The purpose of this study is to evaluate the impact of smoking status after a diagnosis of lung canceron reported pain levels. We conducted a telephone survey of patients with lung cancer identifiedfrom four participating sites between September 2004 and July 2006. Patients were asked to ratetheir usual pain level over the past week on a 0-10 rating scale on which 0 was ‘no pain’ and 10 ‘painas bad as you can imagine’. We operationally defined persistent smokers as patients who reportedcontinuing to smoke after their lung cancer diagnosis. A logistic regression analyses was used to testthe hypothesis that persistent smokers report higher usual pain levels than non-smokers. Overall, 893patients completed the survey. The majority (76%) was found to have advanced cancer (Stages IIIband IV). The mean age was 63 (SD=10). Seventeen percent of the patients studied were categorizedas persistent smokers. The mean pain score for the study sample was 3.1 (sd=2.7) and 41% reportedmoderate (4-6) or severe pain (7-10). A greater proportion of persistent smokers reported moderateor severe pain than non-smokers or former smokers (p<.001). Logistic regression analysis revealedthat, smoking status was associated with the usual pain even after adjusting for age, perceived healthstatus and other lung cancer symptoms such as dyspnea, fatigue and trouble eating. In conclusion,patients who continue to smoke after a diagnosis of lung cancer report higher levels of usual painthan non-smokers or former smokers. More research is needed to understand the mechanisms thatrelate nicotine intake to pain and disease progression in late-stage lung cancer
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