Pain-Related Anxiety and Smoking Lapse/Topography among African American Menthol Smokers with Chronic Low Back Pain

患有慢性腰痛的非裔美国薄荷醇吸烟者与疼痛相关的焦虑和吸烟戒断/地形

• 批准号: 10463584
• 负责人: Justin Shepherd
• 金额: $ 3.74万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10463584
• 关键词: Abstinence; Acute; Address; Adult; Affect; African American; African American population; Analgesics; Anxiety; Asthma; Awareness; Behavior; Cardiovascular Diseases; Chronic; Chronic low back pain; Cigarette; Cigarette Smoker; Clinical; Data; Development; Dimensions; Economics; Fibrinogen; Fright; General Population; Glare; Health Disparities Research; Health Services Accessibility; Hispanic; Hour; Individual; Individual Differences; Intervention; Lead; Maintenance; Malignant Neoplasms; Menthol; Not Hispanic or Latino; Outcome; Pain; Pain intensity; Participant; Patient Self-Report; Pharmacology; Prevalence; Process; Public Health; Relapse; Reporting; Role; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Societies; Stress; Surveys; Symptoms; Tobacco; Tobacco Dependence; Tobacco use; Underserved Population; United States; Withdrawal; Work; analog; chronic pain; cigarette smoking; clinically relevant; coping mechanism; craving; deprivation; design; experience; health disparity; health disparity populations; meetings; mortality; multimodality; novel; pain outcome; pain reduction; physical symptom; precision medicine; preventable death; smoking abstinence; smoking cessation; smoking prevalence; success; therapy design; treatment strategy

I. Project Summary/Abstract Tobacco use is the leading cause of preventable death and disability1 and results in substantial economic burden2. Estimates suggest that 13.7% of adults in the United States (US) are current smokers3. Yet, tobacco use is not equally distributed in society. African American smokers evince elevated smoking rates (14.6%)3 and up to 90% of African American adult smokers use menthol cigarettes compared to just 26% of White smokers4. African American smokers are less likely to maintain cessation compared to non-Hispanic White and Hispanic smokers despite making more quit attempts5. Smokers, in general, report greater pain intensity compared to nonsmokers6 and the rate of smoking among individuals with chronic pain is higher than the rates found within the general population7, 8. In fact, nationally-representative survey data indicates that the prevalence of cigarette smoking among individuals with chronic pain may exceed twice the rate observed in the general population [26-42% compared to 15%]9, 10 and the prevalence of smoking among African Americans with chronic pain, may be even higher given their elevated rates of tobacco use3. Past work also indicates that African Americans report a lower pain threshold11 and lower tolerance to pain12, 13, as well as greater pain-related disability14. Accordingly, there is a critical public health need to better understand tobacco- pain relations among African American menthol smokers with chronic pain. Pain-related anxiety, which reflects concern about pain-related somatic sensations15, may be one underrecognized individual difference factor that may help in understanding smoking maintenance and relapse among African American menthol smokers with chronic pain. Pain-related anxiety may be predictive of smoking lapse behavior for this group as African Americans have an increased awareness of the negative outcomes of aversive somatic symptoms and physical illnesses such as pain symptoms16, 17. Therefore, the purpose of the current project is to understand the role of pain-related anxiety in terms of smoking lapse using a multimodal assessment of smoking behavior (via topography and self-report). The aims of this proposal are designed to demonstrate the importance of a clinically malleable individual difference factor (i.e., pain-related anxiety) for African American menthol smokers with chronic pain. Meeting the aims will have substantial public health significance as they represent progress toward a precision medicine approach to smoking cessation and may lead to the development of culturally tailored interventions for African American menthol smokers with chronic pain that targets the malleable construct of pain-related anxiety.

一、项目概要/摘要 烟草使用是可预防的死亡和残疾的主要原因1，并导致大量 经济负担2.据估计，美国 13.7% 的成年人目前是吸烟者3。然而， 烟草使用在社会中分布不均。非裔美国吸烟者的吸烟率较高 (14.6%)3，高达 90% 的非裔美国成年吸烟者使用薄荷醇卷烟，而这一比例仅为 26% 白人吸烟者4。与非西班牙裔吸烟者相比，非裔美国吸烟者维持戒烟的可能性较小 白人和西班牙裔吸烟者尽管做出了更多的戒烟尝试5。一般来说，吸烟者报告的疼痛更大 与不吸烟者相比6，慢性疼痛患者的吸烟率高于非吸烟者。 在一般人群中发现的比率7, 8。事实上，全国代表性调查数据表明， 患有慢性疼痛的人中吸烟的流行率可能超过在以下人群中观察到的吸烟率的两倍 一般人群 [26-42% 对比 15%]9, 10 以及非洲吸烟率 由于吸烟率较高，患有慢性疼痛的美国人的患病率可能更高3。过去的工作也 表明非裔美国人的疼痛阈值较低11，对疼痛的耐受性较低12、13，以及 与疼痛相关的更大的残疾14。因此，公共卫生方面迫切需要更好地了解烟草 非裔美国薄荷醇吸烟者与慢性疼痛之间的疼痛关系。与疼痛相关的焦虑，反映 对与疼痛相关的躯体感觉的担忧15，可能是一个未被充分认识的个体差异因素， 可能有助于了解非裔美国薄荷醇吸烟者的吸烟维持和复吸情况 慢性疼痛。与疼痛相关的焦虑可能预示着非洲人这一群体的戒烟行为 美国人越来越意识到厌恶性躯体症状的负面后果， 身体疾病，例如疼痛症状16, 17。因此，当前项目的目的是了解 使用吸烟行为的多模式评估研究疼痛相关焦虑在戒烟方面的作用 （通过地形和自我报告）。该提案的目的旨在证明 非裔美国薄荷醇吸烟者的临床可塑性个体差异因素（即与疼痛相关的焦虑） 伴有慢性疼痛。实现这些目标将具有重大的公共卫生意义，因为它们代表着进步 走向戒烟的精准医学方法，并可能导致文化的发展 针对患有慢性疼痛的非洲裔美国薄荷醇吸烟者量身定制的干预措施 疼痛相关焦虑的构建。