Predictors of Severe Nicotine Dependence in Patients with Chronic Pain

The combined presence of chronic pain and nicotine dependence has been shown to elevate the risk of both physical and mental illnesses. Consequently, understanding the interconnected relationship between chronic pain, smoking, and nicotine dependence is crucial for developing effective interventions and improving patient outcomes. The present study aimed to reveal if pain intensity, symptoms of anxiety and depression, anxiety sensitivity, and distress tolerance serve as predictive factors of severe nicotine dependence risk among patients with chronic pain. Seventy-six smokers with chronic pain were recruited (mean age = 50.28±12.37, 63.2% female). The study utilized self-reported measures to assess pain intensity, distress tolerance, anxiety sensitivity, nicotine dependence, and symptoms of anxiety and depression. Univariate binary logistic regression was performed to find the predictors of severe nicotine dependence risk. Among the patients, 34.2% reported anxiety (n=26), and 56.6% reported depression (n=43). The anxiety subscale scores of the HADS (odds ratio = 1.125 [1.016–1.245]) and the total scores of the ASI-3 (odds ratio = 1.038 [1.005–1.073]) significantly predicted severe nicotine dependence risk (p = 0.023 and p = 0.025, respectively), as well as pain intensity over the past week (odds ratio = 1.331[1.030–1.720]; p = 0.029). This study highlights the need to address smoking behavior and mental health in patients with chronic pain and emphasizes the importance of pain management, anxiety symptoms, and anxiety sensitivity as potential targets for intervention in smoking cessation efforts within this population.