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Effects of Smoking Abstinence on Pain Reactivity: A Human Experimental Model

戒烟对疼痛反应性的影响：人体实验模型

基本信息

批准号：
8518285
负责人：
JOSEPH W. DITRE
金额：
$ 14.8万
依托单位：
SYRACUSE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-01 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8518285
关键词：
Abstinence Accounting Acute Affective Animals Area Attention Behavioral Sciences Capsaicin Characteristics Clinical Clinical Trials Comorbidity Development Emotional Etiology Experimental Models Flare Gender General Population Goals Hour Human Individual Inflammation Intervention Knowledge Laboratories Measures Mediating Mediator of activation protein Medical Medicine Modeling Nicotine Nicotine Withdrawal Pain Pain Disorder Pain Threshold Pain intensity Participant Patient Self-Report Patients Persons Physiological Play Primary Hyperalgesias Procedures Psychology Public Health Randomized Relapse Reporting Research Research Personnel Role Secondary Hyperalgesias Severities Smoke Smoker Smoking Smoking Cessation Intervention Symptoms System Testing Tobacco Tobacco Dependence Tobacco smoking Withdrawal base chronic pain clinical practice coping deprivation experience health economics insight neuromechanism public health relevance response smoking cessation smoking prevalence spontaneous pain

项目摘要

DESCRIPTION (provided by applicant): Tobacco dependence and chronic pain are two highly prevalent and comorbid conditions that engender substantial burdens upon individuals and systems. Pain has been shown to motivate smoking, pain patients endorse smoking for pain-coping, and recurring pain may serve as a significant barrier to smoking cessation. Although animal studies have consistently demonstrated increased pain in the context of nicotine deprivation, we are not aware of any studies that tested whether smoking abstinence or nicotine withdrawal may increase pain reactivity in humans. Given the clinical implications of experiencing increased pain as a consequence of abstaining from tobacco, human trials are clearly warranted. Therefore, the main goal of the proposed study is to test, experimentally, the effects of smoking abstinence on self-reported and physiological pain responding among nicotine-dependent tobacco smokers. Participants (N = 198) will be randomized to one of three experimental conditions prior to undergoing pain induction: (1) 24-hour smoking abstinence (SA); (2) two-hour minimal deprivation (MD); and (3) continued smoking (CS). Specifically, we hypothesize that smokers randomized to the SA condition will report lower pain threshold, greater pain intensity, and greater pain unpleasantness during experimental pain induction than smokers randomized to the MD condition, who will, in turn, report lower pain threshold, greater pain intensity, and greater pain-related unpleasantness than smokers randomized to the CS condition (i.e., SA > MD > CS). We also hypothesize that symptoms characteristic of nicotine withdrawal will mediate the relationship between smoking abstinence and pain responding, such that withdrawal severity will be positively associated with increased pain responding. A secondary aim of the proposed study is to explore the influence of additional mechanisms that may mediate or moderate the effect of smoking abstinence on pain responding. We conceptualize the currently proposed study as a prototypical example of translational, cross-disciplinary research that has the potential to inform the development of targeted interventions. We also believe the proposed project will yield findings that enhance scientific knowledge within the medical and behavioral sciences, inform clinical practice with regard to the treatment of both pain and smoking, and challenge current clinical practice paradigms. For example, given evidence that pain is a motivator of smoking, smoking cessation interventions for persons with comorbid pain disorders may be modified to account for the antithetical influence of smoking abstinence-induced amplification of pain. Finally, the current lack of a human laboratory model of pain and smoking that allows for manipulation of both smoking and pain represents a critical barrier to progress in this broad domain.

描述（由申请人提供）：烟草依赖和慢性疼痛是两种非常普遍且合并症的疾病，给个人和系统带来了巨大的负担。疼痛已被证明是吸烟的动机，疼痛患者支持吸烟来应对疼痛，反复出现的疼痛可能是戒烟的一个重要障碍。尽管动物研究一直表明，在尼古丁剥夺的情况下，疼痛会增加，但我们并不知道有任何研究测试了戒烟或尼古丁戒断是否会增加人类的疼痛反应。考虑到戒烟会增加疼痛的临床意义，人体试验显然是有必要的。因此，本研究的主要目的是通过实验来检验戒烟对尼古丁依赖吸烟者自我报告和生理疼痛反应的影响。参与者（N = 198）在进行疼痛诱导前将被随机分配到三种实验条件之一：(1)24小时戒烟（SA）；(2)两小时最小剥夺（MD）；(3)继续吸烟（CS）。具体来说，我们假设随机分配到SA组的吸烟者在实验疼痛诱导过程中会比随机分配到MD组的吸烟者报告更低的疼痛阈值、更大的疼痛强度和更大的疼痛不愉快，而MD组的吸烟者又会比随机分配到CS组的吸烟者报告更低的疼痛阈值、更大的疼痛强度和更大的疼痛相关不愉快（即SA > MD > CS）。我们还假设尼古丁戒断的症状特征将介导戒烟与疼痛反应之间的关系，因此戒断的严重程度将与疼痛反应的增加呈正相关。本研究的第二个目的是探索可能介导或缓和戒烟对疼痛反应影响的其他机制的影响。我们将目前提出的研究概念化为翻译，跨学科研究的典型例子，该研究有可能为有针对性的干预措施的发展提供信息。我们还相信，拟议的项目将产生增强医学和行为科学领域的科学知识的发现，为治疗疼痛和吸烟的临床实践提供信息，并挑战当前的临床实践范式。例如，鉴于有证据表明疼痛是吸烟的诱因，对患有共病疼痛障碍的人的戒烟干预措施可以进行修改，以解释戒烟引起的疼痛放大的相反影响。最后，目前缺乏疼痛和吸烟的人类实验室模型，该模型允许对吸烟和疼痛进行操作，这是在这一广泛领域取得进展的关键障碍。

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The relation between pain-related fear and disability: a meta-analysis.

DOI：
10.1016/j.jpain.2013.05.005
发表时间：
2013-10
期刊：
JOURNAL OF PAIN
影响因子：
4
作者：
Zale, Emily L.;Lange, Krista L.;Fields, Sherecce A.;Ditre, Joseph W.
通讯作者：
Ditre, Joseph W.

Associations between chronic pain status, attempts to quit smoking, and use of pharmacotherapy for smoking cessation.

慢性疼痛状况，试图戒烟和使用药物疗法戒烟之间的关联。

DOI：
10.1037/a0032515
发表时间：
2014-03
期刊：
PSYCHOLOGY OF ADDICTIVE BEHAVIORS
影响因子：
3.4
作者：
Zale, Emily L.;Ditre, Joseph W.
通讯作者：
Ditre, Joseph W.

Smokers in pain report lower confidence and greater difficulty quitting.

DOI：
10.1093/ntr/ntu077
发表时间：
2014-09
期刊：
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
影响因子：
0
作者：
Emily L. Zale;J. Ditre;M. Dorfman;Bryan W. Heckman;T. Brandon
通讯作者：
Emily L. Zale;J. Ditre;M. Dorfman;Bryan W. Heckman;T. Brandon

Tobacco cigarette smokers who endorse greater intolerance for nicotine withdrawal also report more severe insomnia symptoms.