Increasing Cessation Motivation and Treatment Engagement among Smokers in Pain

Syracuse University, Syracuse NY

Investigators

Linked publications & trials

Abstract

? DESCRIPTION (provided by applicant): Pain and tobacco smoking are both critical national health problems, and there is mounting evidence that smokers in pain may represent an important and large subgroup who experience unique barriers and greater difficulty quitting. Smoking has been identified as a risk factor in the onset and exacerbation of chronic pain, and smokers experience greater levels of pain intensity and disability, relative to non-smokers. Initia evidence indicates that quitting smoking may improve pain outcomes (e.g., lower pain intensity) and supports the notion that smoking cessation may be an essential behavior change for smokers in pain. However, the vast majority of smokers are not yet ready to engage a serious quit attempt, and evidence-based treatments for smoking cessation remain dramatically underutilized. Therefore, the primary goal of the current study is to test a brief intervention tha will address smoking in the context of pain in order to increase motivation to quit smoking and engagement of available smoking cessation treatment. This will be accomplished via adaptation of an evidence-based motivational smoking intervention to include a novel psychoeducation component designed to increase participant knowledge of pain-smoking interrelations, and to develop discrepancy between continued smoking and desired pain outcomes. Participants will be randomized to either the adapted brief motivational intervention or treatment as usual. Based on theoretical conceptualizations of health behavior change and empirical evidence that providing smokers with clear and explicit links between smoking and illness increases motivation to quit, it is our contention that smokers in pain will become more motivated to quit and engage treatment, once they understand how continued smoking may serve to increase their pain. Given the applicant's interests in application of a cross-disciplinary, translational approach to the treatment of co-occurring pain and tobacco dependence, this study represents a necessary and important next step in a systematic line of research that has the potential to inform clinical practice. This award would allow the applicant to receive training from experts in the treatment of addictive behaviors and chronic medical conditions, the development and implementation of clinical trials, and integrated healthcare models. The applicant will also furthe her training in statistical methodology and clinical intervention skills relevant to translational research, and she will complete graduate coursework pertinent to her research and career interests. Finally, this award will facilitate further development of the applicant's research program via completion of manuscripts, presentation of research findings at multiple scientific meetings, and development of additional novel research questions. Ultimately, the applicant is committed to pursuing a career as an independent, NIH-funded researcher, including obtaining a post-doctoral fellowship or faculty position that will allow her to pursue a systematic line of translational research that identifies mechanisms underlying associations between pain and substance use and informs development of novel interventions.