Anxiety sensitivity, pain severity and co-use of cigarettes and e-cigarettes among adults with chronic pain

Differences in Pain Severity and Interference between Latinx Combustible Cigarette Smokers and Dual Users with Current Pain

Latinx individuals who smoke represent a tobacco health disparities group. Yet, limited research has focused on examining dual combustible and electronic cigarette use among Latinx populations. Importantly, Latinx persons who smoke also evince elevated rates of pain problems and symptoms and prior research has consistently linked pain problems and severity to smoking prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among dual combustible cigarette and electronic cigarette Latinx users comparing levels of pain severity and interference. The current sample consists of 196 adult Latinx daily cigarette smokers (35.48 years old; 39.4% female), of which 72 reported current daily dual use of an e-cigarette. Results indicated that Latinx dual users reported greater levels of pain severity (ηp2 = .12) and pain interference (ηp2 = .10) than exclusive combustible cigarette users. The study adds uniquely to the limited literature on the clinical importance of dual cigarette use in relation to pain severity and interference in that pain may serve as an important risk factor for the initiation and maintenance of dual use for increased analgesic nicotine effects.

The risk profile of electronic nicotine delivery systems, compared to traditional cigarettes, on oral disease: a review

The use of electronic nicotine delivery systems (ENDS) has exploded, especially among teenagers and new smokers, amid widespread awareness of the dangers of traditional tobacco and restrictions on smoking. However, the risk effects of ENDS on physical health, especially oral health, are still ambiguous. The purpose of this study was to review the available evidence on risks of ENDS on oral health, and compares the differences between ENDS and traditional cigarettes. For heavy smokers, transferring the addiction of tobacco to ENDS can be less harmful to periodontal condition and physical health but is not completely without risk. The components of ENDS vapor have cytotoxic, genotoxic, and carcinogenic properties, and its usage may be associated with a wide range of oral health sequelae. The chemicals in ENDS increase the susceptibility to tooth decay, increase the risk of periodontal disease, peri-implant, and oral mucosal lesions. Nicotine aerosols from ENDS can be a potential risk factor for oral cancer due to the presence of carcinogenic components. Compared to smoking traditional cigarettes, the harm associated with ENDS use may be underestimated due to the reduced ability to control vaping behavior, ease of ENDS access, fewer vaping area restrictions, and better taste. Currently, the available evidence suggests that ENDS may be a safer alternative to traditional tobacco products. Though most oral symptoms experienced by ENDS users are relatively mild and temporary compared to traditional cigarettes, the dangers of ENDS still exist. However, further research with longer follow-up periods is required to establish the long-term safety of ENDS.

The Relationship of Tobacco Use and Migraine: A Narrative Review

PURPOSE OF REVIEW

Tobacco use is associated with significant health consequences especially for people with medical conditions. Although lifestyle strategies (e.g., sleep, diet) are commonly recommended as part of migraine treatment, tobacco-related strategies (e.g., smoking cessation) are rarely included. This review is aimed at elucidating what is known about tobacco use and migraine and at identifying gaps in the research.

RECENT FINDINGS

The prevalence of smoking is higher among people with migraine, and people with migraine believe that smoking makes migraine attacks worse. There is also evidence that smoking may exacerbate migraine-related consequences (e.g., stroke). Very few studies have examined other aspects of smoking and migraine or tobacco products other than cigarettes. There are significant gaps in our knowledge of smoking and migraine. More research is needed to understand the relationship of tobacco use to migraine and potential benefits of adding smoking cessation efforts into migraine care.

Longitudinal Associations Between Pain and Use of Cigarettes and E-cigarettes in the Population Assessment of Tobacco and Health (PATH) Study

INTRODUCTION

Pain has been implicated in the onset and maintenance of nicotine addiction, and there is initial cross-sectional evidence of covariation between pain and the use of cigarettes and e-cigarettes. The goals of the current study were to: (1)test pain severity as a predictor of initiating co-use of cigarettes and e-cigarettes, (2)examine longitudinal associations between pain and use/co-use of cigarettes and e-cigarettes, (3)generate the first prevalence rate data regarding cigarette and e-cigarette use as a function of pain, and (4)examine gender as a moderator of these associations.

AIMS AND METHODS

Data were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health Study (2013-2018).

RESULTS

Among exclusive cigarette smokers at Wave 1 (n = 7719), pain severity was associated with a greater likelihood of and faster trajectory to initiating co-use of cigarettes and e-cigarettes (ps < .05). A significant pain × gender interaction (p < .05) revealed this prospective relationship was stronger among women. Among adult respondents who provided at least three waves of data (n = 24 255), greater Wave 1 pain severity was positively associated with e-cigarette use, cigarette smoking, and co-use of cigarettes and e-cigarettes at Waves 2, 3, and 4 (ps < .001). At Wave 4 (n = 33 822), adults with moderate or severe pain endorsed rates of e-cigarette and cigarette use almost two times greater versus no or low pain (ps < .001).

CONCLUSIONS

Collectively, these findings provide evidence that pain likely serves as an important candidate risk factor for the initiation and maintenance of cigarette and e-cigarette use.

IMPLICATIONS

This is the first prospective study to show that pain serves as an important risk factor for initiation and maintenance of cigarette and e-cigarette use over time. Weighted prevalence estimates further demonstrated that individuals with moderate or severe pain endorsed rates of cigarette and e-cigarette use and co-use approximately two times greater compared to those with no or low pain. These findings highlight a subpopulation of nicotine users more susceptible to greater healthcare burden, nicotine dependence, and physical impairment. Nicotine users with comorbid pain may benefit from integrated interventions that address pain in the context of cessation.

Lifestyle and chronic pain: double jeopardy?

Given the often disappointing results of pharmacotherapy, many patients with chronic pain seek to modify their lifestyle. Some lifestyle factors, such as the consumption of alcohol, tobacco, cannabis, or psychostimulants, are deleterious in this context, whereas others, such as physical activity and a balanced diet, are considered beneficial, but these require substantial effort on the part of patients. In all cases, it is important to analyse lifestyle factors in patients with chronic pain, without stigmatisation, as the co-existence of pain and inappropriate behaviour can be seen as double jeopardy in patients with pain.

The Impact of Smoking on the Development and Severity of Chronic Pain

PURPOSE OF REVIEW

The purpose of this review is to examine the impact of smoking and its role on the development of chronic pain and provide a critical review of recent literature.

RECENT FINDINGS

Recent studies demonstrate the bidirectional and dependent relationship between smoking and chronic pain. Those who are in pain have a more difficult time in the cessation of smoking as well as an increased sensitivity to pain during abstinence, lower confidence, and higher relapse rates. The fear of pain and the anxiety and depression that abstinence causes results in a grim outcome for long-term cessation. The dependent nature between chronic pain and smoking is affected by numerous variables. Providers should consider a multiprong approach to treating chronic pain and targeting smoking cessation treatment by providing motivational therapy, nicotine replacement, and medication therapies to prevent relapse, and providing those who are more likely to relapse with a higher level of care.

Cannabis use and electronic cigarette use: The role of dual use on use frequency and related problems

Despite high rates of use of both cannabis and electronic nicotine delivery systems (ENDS), little is known about the role of cannabis use among ENDS users and of ENDS use among cannabis users. This study tested whether dual use was related to more frequent use, use-related problems, and negative affect. Among cannabis users (n=315), ENDS was associated with more frequent cannabis use, cannabis-related problems, anxiety, and depression. Among ENDS users (n=156), cannabis was associated with more frequent ENDS use, ENDS-related problems, and anxiety. Overall, ENDS use is common among cannabis users and cannabis use is common among ENDS users. Further, use of both of these substances is related to more use, use-related problems, and negative affect, especially anxiety.

(E)-3-furan-2-yl-N-phenylacrylamide (PAM-4) decreases nociception and emotional manifestations of neuropathic pain in mice by α7 nicotinic acetylcholine receptor potentiation

Clinical intervention of pain is often accompanied by changes in affective behaviors, so both assays of affective and sensorial aspects of nociception play an important role in the development of novel analgesics. Although positive allosteric modulation (PAM) of α7 nicotinic acetylcholine receptors (nAChRs) has been recognized as a novel approach for the relief of sensorial aspects of pain, their effects on affective components of pain remain unclear. Therefore, we investigated whether PAM-4, a highly selective α7-nAChR PAM, attenuates inflammatory and neuropathic pain, as well as the concomitant depressive/anxiety comorbidities. The anti-nociceptive activity of PAM-4 was assessed in mice using the formalin test and chronic constriction injury (CCI)-induced neuropathic pain model. The anxiolytic- and antidepressant-like activity of PAM-4 was evaluated using the marble burying test and forced swimming test. Acute systemic administration of PAM-4 dose-dependently reversed formalin-induced paw licking behavior and CCI-induced mechanical allodynia without development of any motor impairment. PAM-4 reversed the decreased swimming time and number of buried marbles in CCI-treated mice, suggesting that this ligand attenuates chronic pain-induced depression-like behavior and anxiogenic-like effects. The effects of PAM-4 were inhibited by the α7-selective antagonist methyllycaconitine, indicating molecular mechanism mediated by α7-nAChRs. Indeed, electrophysiological recordings showed the PAM-4 enhances human α7 nAChRs with higher potency and efficacy compared to rat α7 nAChRs. These findings suggest that PAM-4 reduces both sensorial and affective behaviors induced by chronic pain in mice by α7-nAChR potentiation. PAM-4 deserves further investigations for the management of chronic painful conditions with comorbidities.