Pain, nicotine, and smoking: research findings and mechanistic considerations.
Pain, nicotine, and smoking: research findings and mechanistic considerations.
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DOI：
10.1037/a0025544
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发表时间：
2011-11
影响因子：
22.4
通讯作者：
Meagher MM
中科院分区：
文献类型：
--
作者：
Ditre JW;Brandon TH;Zale EL;Meagher MM
烟草成瘾和慢性疼痛是两种高度普遍且共存的疾病，给个人和系统带来沉重负担。尽管疼痛和吸烟之间的相互关系几十年来一直引起临床和实证研究的兴趣，但在过去五年中，关于疼痛、尼古丁和吸烟主题的研究急剧增加。我们将疼痛和吸烟的相互作用概念化为生物心理社会模型的典型例子。因此，当前的综述从行为、认知、情感、生物医学和社会角度进行推断，提出可能导致这两种情况之间观察到的共病的因果机制。疼痛和吸烟这一广泛领域的研究首先被分为“吸烟对疼痛的影响”或“疼痛对吸烟的影响”的研究。然后，我们整合现有文献，提出疼痛和吸烟的相互模型，假设该模型以正反馈循环的方式相互作用，导致更大的疼痛、吸烟增加和烟草成瘾的维持。最后，我们提出了未来的研究方向，并讨论了对患有共病疼痛疾病的吸烟者的临床意义。我们观察到适度的证据支持这一观点，即吸烟可能是某些慢性疼痛病症的多因素病因学的危险因素，并且疼痛的经历可能成为吸烟的有力动机。我们还发现，虽然动物研究一致支持尼古丁和烟草烟雾的直接疼痛抑制作用，但人体研究的结果却不太一致。疼痛和吸烟这一新兴领域的未来研究有可能为吸烟、慢性疼痛及其共病表现的理论和临床应用提供信息。
Tobacco addiction and chronic pain represent two highly prevalent and comorbid conditions that engender substantial burdens upon individuals and systems. Although interrelations between pain and smoking have been of clinical and empirical interest for decades, research on the topic of pain, nicotine, and tobacco smoking has increased dramatically over the past five years. We conceptualize the interaction of pain and smoking as a prototypical example of the biopsychosocial model. Accordingly, the current review extrapolated from behavioral, cognitive, affective, biomedical, and social perspectives to propose causal mechanisms that may contribute to the observed comorbidity between these two conditions. Research in the broad area of pain and smoking was first dichotomized into investigations of either "effects of smoking on pain" or "effects of pain on smoking." We then integrated the extant literature to present a reciprocal model of pain and smoking that is hypothesized to interact in the manner of a positive feedback loop, resulting in greater pain, increased smoking, and the maintenance of tobacco addiction. Finally, we proposed directions for future research, and discussed clinical implications for smokers with comorbid pain disorders. We observed modest evidence to support the notions that smoking may be a risk factor in the multifactorial etiology of some chronically painful conditions, and that the experience of pain may come to serve as a potent motivator of smoking. We also found that whereas animal studies yielded consistent support for direct pain-inhibitory effects of nicotine and tobacco smoke, results from human studies were much less consistent. Future research in the emerging area of pain and smoking has the potential to inform theoretical and clinical applications with respect to tobacco smoking, chronic pain, and their comorbid presentation.
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影响因子：
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