. Chronic pain affects more than 50 million Americans per year and is the third leading cause of physical impairment in the United States, following cancer and heart disease. Tobacco use, particularly cigarette smoking, has an economic impact of over $167 billion annually, harms nearly every organ of the body, and remains the leading preventable cause of death in the United States. The prevalence of smoking among chronic pain patients is approximately double that of the general population. Research suggests that smoking may be a risk factor for the development and exacerbation of chronically painful conditions. However, consistent with evidence of smoking-related analgesia, most patients declare a need to smoke when in pain, and positive correlations between pain intensity and number of cigarettes smoked have been reported. Furthermore, a recent study by the applicant provided the first experimental evidence that situational pain is a potent motivator of smoking. The main goal of the proposed study is to test the causal relationship between pain and smoking motivation by manipulating potential mediating and moderating variables, as influenced by social learning theory-based conceptualizations of pain coping and addiction motivation. A total of 132 smokers will be randomly assigned to one of four conditions in this 2X2 crossed factorial between-subjects design. We hypothesize that, following pain induction, manipulations designed to (1) enhance pain-related coping behaviors, and (2) diminish smoking-related outcome expectancies will each reduce motivation to smoke, when compared to control conditions. We will also test for an interactive, synergistic effect between the two manipulations. The first factor manipulates a variable that the pain literature has shown to predict reduced pain reactivity, whereas the second factor manipulates a variable that has been shown in the smoking literature to influence smoking motivation. Thus, the current proposal draws upon both the pain and smoking literature. Relevance. This experimental design will allow us to test theoretical mechanisms that may underlie and impact the causal relationship between pain and enhanced smoking motivation. This design will also serve as an analogue test of variables that may merit further investigation for their capacity to influence the development of interventions targeted at individuals with comorbid pain and addiction disorders. The ultimate goals of this line of research are to better understand the relationship between smoking and chronic pain, and to develop smoking prevention, cessation, and relapse prevention interventions targeted at individuals who endure chronic pain. ? ? ?
| Ditre, Joseph W; Oliver, Jason A; Myrick, Hugh et al. (2012) Effects of divalproex on smoking cue reactivity and cessation outcomes among smokers achieving initial abstinence. Exp Clin Psychopharmacol 20:293-301 |
| Ditre, Joseph W; Brandon, Thomas H; Zale, Emily L et al. (2011) Pain, nicotine, and smoking: research findings and mechanistic considerations. Psychol Bull 137:1065-93 |
| Ditre, Joseph W; Gonzalez, Brian D; Simmons, Vani N et al. (2011) Associations between pain and current smoking status among cancer patients. Pain 152:60-5 |
| Ditre, Joseph W; Heckman, Bryan W; Butts, Emily A et al. (2010) Effects of expectancies and coping on pain-induced motivation to smoke. J Abnorm Psychol 119:524-33 |
