Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars
Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars
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DOI：
10.1093/pm/pnw223
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发表时间：
2017-06-01
期刊：
影响因子：
3.1
通讯作者：
Haskell, Sally G.
中科院分区：
文献类型：
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作者：
Bastian, Lori A.;Driscoll, Mary A.;Haskell, Sally G.
Objective.吸烟者寻求治疗慢性疼痛的阿片类药物使用率高于非吸烟者。这项研究的目的是检查吸烟的持久自由行动/伊拉克自由/新黎明（OEF/OIF/OND）的退伍军人是否比不吸烟者更有可能接受阿片类药物处方，并根据当前的疼痛强度进行调整。OEF/OIF/OND退伍军人队列研究的横断面分析，这些退伍军人在2001年至2012年期间至少去过一次退伍军人健康管理局初级保健诊所。吸烟状态被定义为当前、既往和从未吸烟。基于0-10数字评定量表，当前疼痛强度（吸烟状态的1/2 30天）被分类为无疼痛/轻度（0-3）和中度/重度（4-10）。接受阿片类药物定义为至少一个处方填写1/2 30天的吸烟状态。我们确定了406,954名OEF/OIF/OND退伍军人：平均年龄为30岁，12.5%为女性（n=50,988），66.3%报告无疼痛或轻度疼痛强度，33.7%报告中度或重度疼痛强度，37.2%为当前吸烟者，16%为既往吸烟者。总体而言，33，960名（8.3%）退伍军人接受了一种或多种阿片类药物处方。在控制了其他协变量后，与从不吸烟者相比，目前吸烟（比值比[OR] = 1.56，95%可信区间[CI] = 1.52-1.61）和既往吸烟（OR = 1.27，95%CI = 1.22-1.32）与接受阿片类药物处方的可能性更高相关。我们发现吸烟状况与接受阿片类药物处方之间存在关联。目前吸烟者的效果比前吸烟者更强，这突出表明需要确定戒烟是否与退伍军人中阿片类药物使用的减少有关。
Objective. Cigarette smokers seeking treatment for chronic pain have higher rates of opioid use than nonsmokers. This study aims to examine whether veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who smoke are more likely to receive an opioid prescription than nonsmokers, adjusting for current pain intensity.Design. Cross-sectional analysis of a cohort study of OEF/OIF/OND veterans who had at least one visit to a Veterans Health Administration primary care clinic between 2001 and 2012.Methods. Smoking status was defined as current, former, and never. Current pain intensity (1/2 30 days of smoking status), based on the 0-10 numeric rating scale, was categorized as no pain/mild (0-3) and moderate/severe (4-10). Opioid receipt was defined as at least one prescription filled1/2 30 days of smoking status.Results. We identified 406,954 OEF/OIF/OND veterans: The mean age was 30 years, 12.5% were women (n=50,988), 66.3% reported no pain or mild pain intensity, 33.7% reported moderate or severe pain intensity, 37.2% were current smokers, and 16% were former smokers. Overall, 33,960 (8.3%) veterans received one or more opioid prescription. Current smoking (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.52-1.61) and former smoking (OR = 1.27, 95% CI = 1.22-1.32) were associated with a higher likelihood of receipt of an opioid prescription compared with never smoking, after controlling for other covariates.Conclusions. We found an association between smoking status and receipt of an opioid prescription. The effect was stronger for current smokers than former smokers, highlighting the need to determine whether smoking cessation is associated with a reduction in opioid use among veterans.