Persistent Smoking After a Diagnosis of Lung Cancer Is Associated With Higher Reported Pain Levels
Persistent Smoking After a Diagnosis of Lung Cancer Is Associated With Higher Reported Pain Levels
复制标题
DOI：
10.1016/j.jpain.2008.10.006
复制
发表时间：
2009-03-01
期刊：
影响因子：
4
通讯作者：
Bastian, Lori A.
中科院分区：
文献类型：
--
作者：
Daniel, Marcella;Keefe, Francis J.;Bastian, Lori A.
本研究的目的是评估肺癌诊断后吸烟状态对报告疼痛水平的影响。我们对2004年9月至2006年7月期间从4个参与研究中心确定的肺癌患者进行了电话调查。患者被要求在0到10的评分表上对他们过去一周的疼痛水平进行评分，0表示“没有疼痛”，10表示“疼痛如你所能想象的那样严重”。“我们在操作上将持续吸烟者定义为在肺癌诊断后报告继续吸烟的患者。采用逻辑回归分析来检验持续吸烟者比不吸烟者报告更高的日常疼痛水平的假设。共有893名患者完成了调查。大多数（76%）被发现患有晚期癌症（IIIb和IV期）。平均年龄为63岁（SD = 10）。17%的患者被归类为持续吸烟者。研究样本的平均疼痛评分为3.1（SD = 2.7），41%报告中度（4 - 6）或重度疼痛（7 - 10）。持续吸烟者报告中度或重度疼痛的比例高于不吸烟者或前吸烟者（P <0.001）。Logistic回归分析显示，即使在调整了年龄、自觉健康状况和其他肺癌症状（如呼吸困难、疲劳和进食困难）后，吸烟状况仍与常见疼痛相关。总之，诊断为肺癌后继续吸烟的患者报告的日常疼痛水平高于不吸烟者或前吸烟者。需要更多的研究来了解尼古丁摄入与晚期肺癌疼痛和疾病进展相关的机制。这篇文章探讨了肺癌患者疼痛和持续吸烟之间的关系。尽管还需要更多的研究来了解尼古丁摄入与疼痛和疾病进展之间的关系，医生可以促进肺癌患者戒烟，以改善健康和生活质量。(C)2009年美国疼痛协会
The purpose of this study was to evaluate the impact of smoking status after a diagnosis of lung cancer on reported pain levels. We conducted a telephone survey of patients with lung cancer identified from 4 participating sites between September 2004 and July 2006. Patients were asked to rate their usual pain level over the past week on a 0 to 10 rating scale on which 0 was "no pain" and 10 "pain as bad as you can imagine." We operationally defined persistent smokers as patients who reported continuing to smoke after their lung cancer diagnosis. A logistic regression analysis was used to test the hypothesis that persistent smokers report higher usual pain levels than nonsmokers. Overall, 893 patients completed the survey. The majority (76%) was found to have advanced cancer (stages IIIb and IV). The mean age was 63 years (SD = 10). Seventeen percent of the patients studied were categorized as persistent smokers. The mean pain score for the study sample was 3.1 (SD = 2.7) and 41% reported moderate (4 to 6) or severe pain (7 to 10). A greater proportion of persistent smokers reported moderate or severe pain than nonsmokers or former smokers (P < .001). Logistic regression analysis revealed that smoking status was associated with the usual pain even after adjusting for age, perceived health status, and other lung cancer symptoms such as dyspnea, fatigue, and trouble eating. In conclusion, patients who continue to smoke after a diagnosis of lung cancer report higher levels of usual pain than nonsmokers or former smokers. More research is needed to understand the mechanisms that relate nicotine intake to pain and disease progression in late-stage lung cancer.Perspective: This article examines the relationship between pain and persistent smoking in patients with lung cancer Although more research is needed to understand the mechanisms that relate nicotine intake to pain and disease progression, physicians can promote smoking cessation in patients with lung cancer to improve health and quality of life. (C) 2009 by the American Pain Society