Presented at the 2012 AAPM Annual Meeting « Back

Differences in Cancer Pain and Symptom Burden and Opioid Misuse Risk Between Non-Smokers and Smokers

Diane Novy, PhD, dnovy@mdanderson.org¹, Dhanalakshmi Koyyalagunta, MD¹, Larry C. Driver, MD¹, Mike Hernandez, MS¹, Cho Lam, PHD¹, Ellen R. Gritz, PHD², (1) University of Texas MD Anderson Cancer Center, Houston, Texas, (2) APA, Houston, Texas

Introduction: Preliminary studies suggest smokers experience more pain and collateral symptom burden of cancer than non-smokers. Among chronic pain patients, smokers tend to be at greater risk for opioid misuse. Unlike previous studies, we investigated more symptoms and opioid misuse risk among non-smokers and smokers with cancer pain. Methods: The participants (393 non-smokers; 95 smokers) were new patients at the Pain Management Center of The University of Texas MD Anderson Cancer Center. As part of their new patient intake, they completed the Edmonton Symptom Assessment Scale (ESAS) and the Screener and Opioid Assessment for Patients with Pain (SOAPP). Results: Smokers had statistically significant worse usual pain intensity, fatigue, poor appetite, depression, anxiety, and insomnia than non-smokers. Smokers reported more shortness of breath and difficulty thinking, although these differences were not statistically significant. Smokers more often than non-smokers reported a history or current problems with mood swings, use of medication other than the way it was prescribed, use of illegal drugs, and legal problems. Conclusions: Our finding that smokers have higher pain intensity and symptom burden than non-smokers is consistent with the existing literature. Unlike previous studies, however, our investigation included a larger range of symptoms. In a previous study with patients with chronic non-cancer pain, smokers were at higher risk for opioid misuse than non-smokers. Our study confirmed similar findings in a cancer pain sample. The findings from this study will guide subsequent studies and inform clinical practice, including a role for tobacco treatment in pain management.

Funding: None