Smokers in Pain Report Lower Confidence and Greater Difficulty Quitting

Introduction: Pain and tobacco smoking are both highly prevalent and comorbid conditions, and there is reason to believe that pain may pose a barrier to smoking cessation. Although motivation to quit smoking and abstinence self-efficacy have been shown to predict future quit attempts and smoking cessation outcomes, little is known about how these factors may differ as a function of pain status. The goal of the current study was to test cross-sectional relations between past-month pain and self-reported motivation to quit smoking, recent difficulty quitting, and current abstinence self-efficacy. Methods: Current daily smokers were recruited from the local community to participate in a laboratory study that included a baseline assessment of recent pain and smoking history. Results: Approximately 59% of 132 smokers endorsed past-month pain. Consistent with hypotheses, smokers who endorsed past-month pain reported lower confidence in their ability to remain abstinent and having experienced greater difficulty during their most recent quit attempt (ps < .03). Smokers in pain also endorsed greater motivation to quit and were more than twice as likely (odds ratio = 2.74, 95% confidence interval = 1.28-5.84) to be classified in the contemplation/preparation (vs. precontemplation) stages, relative to pain-free smokers. Conclusions: To our knowledge, this is the first study to demonstrate an association between positive pain status, recent difficulty quitting smoking, and reduced self-efficacy for future smoking abstinence. These findings support the utility of assessing pain among all smokers and may help to inform future intervention efforts aimed at helping persons in pain quit smoking.