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

烟草与健康人群评估 (PATH) 研究中疼痛与使用香烟和电子烟之间的纵向关联

• 批准号: 10312504
• 负责人: Jessica M Powers
• 金额: $ 3.52万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10312504
• 关键词: Absence of pain sensation; Accounting; Acute; Address; Analgesics; Area; Award; Behavioral Sciences; Cigarette; Cigarette Smoker; Clinical; Clinical Psychology; Collaborations; Complex; Data; Data Collection; Dependence; Development; Discipline; Drug usage; Economic Burden; Educational workshop; Electronic cigarette; Etiology; Faculty; Fellowship; Female; Foundations; Frequencies; Funding; General Population; Goals; Health; High Prevalence; Individual; Intake; Interdisciplinary Study; Knowledge; Lead; Learning Skill; Link; Longitudinal Studies; Longitudinal cohort; Maintenance; Medical; Medical Care Costs; Modeling; National Institute of Drug Abuse; Nature; Neurobiology; Nicotine; Nicotine Use Disorder; Outcome; Pain; Pain intensity; Pain interference; Participant; Peptide Initiation Factors; Persons; Population Analysis; Population Assessment of Tobacco and Health; Positioning Attribute; Postdoctoral Fellow; Prevalence; Productivity; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Self Administration; Sex Differences; Smoker; Smoking Behavior; Testing; Time; Tobacco; Tobacco Dependence; Tobacco use; Training; United States National Institutes of Health; biological sex; career; cigarette smoking; clinical practice; cohort; combustible cigarette; comorbidity; coping; economic impact; electronic cigarette use; experience; interest; male; meetings; nicotine cessation; nicotine craving; nicotine exposure; nicotine use; nicotine user; novel; pain processing; prospective; substance use; tobacco exposure; tobacco products

PROJECT SUMMARY/ABSTRACT Nicotine/tobacco use and pain are highly prevalent, frequently co-occur, and engender a substantial annual economic burden in medical costs and lost productivity.1-4 Rates of nicotine use are considerably higher among persons with co-occurring pain (vs. the general population),1, 2 and empirical studies have elucidated bidirectional associations between pain and nicotine/tobacco use/dependence. Nicotine can produce acute analgesic effects,5 and pain can be a potent motivator of nicotine/tobacco use for pain-coping.6 Furthermore, greater nicotine exposure has been linked to the development and exacerbation of pain.7-9 Despite increasing empirical focus on pain and nicotine use reciprocity, a majority of this research to date has focused solely on relations between pain and combustible cigarette smoking. Use of electronic cigarettes (e-cigarettes) has drastically increased over the past decade,10, 11 co-use of cigarettes and e-cigarettes is increasingly common,12 and individuals with pain may be uniquely at risk for initiation and escalation of use/co-use of e-cigarettes and cigarettes.13-15 Therefore, the goal of this proposal is to conduct the first longitudinal study of pain and use/co- use of e-cigarettes and tobacco cigarettes utilizing four waves of nationally representative cohort data collected for the Population Assessment of Tobacco and Health (PATH) Study.16 First, the proposed study will assess whether smokers with co-occurring pain (vs. no/low pain) are more likely to initiate co-use of e-cigarettes. Second, pain will be examined as a prospective predictor of (a) likelihood of cigarette and e-cigarette use/co- use, and (b) trajectories of use/co-use over time. It is hypothesized that individuals with pain will be more likely to use e-cigarettes and/or cigarettes and will increase frequency and heaviness of use across all four waves. Finally, biological sex will be examined as a moderator of the hypothesized relationships, given known sex differences in both the experience of pain and nicotine consumption. Completion of this project may advance research and clinical practice by establishing pain as a significant, yet under-recognized risk factor in the onset and escalation of nicotine consumption (via cigarettes and/or e-cigarettes). This proposal is consistent with NIDA’s stated goal of understanding the complex interactions of factors, such as medical comorbidities, that influence drug use trajectories.17 This award would provide resources and protected time to further the applicant’s training in several key areas, including increasing knowledge of pain and use of alternative nicotine/tobacco products and learning skills relevant to analysis of population-level data and trajectory modeling. The trainings, workshops, and collaborations necessary to complete the proposed project aims would be otherwise unavailable through the applicant’s clinical psychology graduate studies and placement requirements. The applicant is committed to pursuing a career as an independent NIH-funded researcher, and aims to obtain a post-doctoral fellowship and subsequent faculty position that will allow her to pursue a programmatic line of multidisciplinary research in the rapidly emerging domain of pain and substance use.

项目概要/摘要 尼古丁/烟草的使用和疼痛非常普遍，经常同时发生，每年都会造成大量的损失。 医疗费用和生产力损失带来的经济负担。1-4 尼古丁使用率要高得多 患有同时发生疼痛的人（相对于一般人群）1, 2 和实证研究已阐明 疼痛与尼古丁/烟草使用/依赖之间的双向关联可以产生急性症状。 镇痛作用 5 和疼痛可能是使用尼古丁/烟草应对疼痛的强大动力。 6 此外， 接触更多的尼古丁与疼痛的发生和加剧有关。7-9 实证重点是疼痛和尼古丁使用的相互作用，迄今为止，这项研究的大部分内容仅集中在 疼痛与吸烟之间的关系。 过去十年急剧增加，10, 11 香烟和电子烟的同时使用越来越普遍，12 患有疼痛的人可能特别面临开始和升级使用/共同使用电子烟的风险 香烟。13-15 因此，该提案的目标是对疼痛和使用/共同进行首次纵向研究 利用收集的四波全国代表性队列数据来了解电子烟和烟草卷烟的使用情况 烟草与健康人口评估 (PATH) 研究。 16 首先，拟议的研究将评估 伴有疼痛（与无疼痛/低度疼痛）的吸烟者是否更有可能开始同时使用电子烟。 其次，将检查疼痛作为以下因素的前瞻性预测因素：(a) 使用香烟和电子烟/同时使用香烟和电子烟的可能性 使用，以及 (b) 随着时间的推移使用/共同使用的轨迹。 使用电子烟和/或香烟，并将增加所有四波使用电子烟和/或香烟的频率和强度。 最后，考虑到已知的性别，生物性别将作为探索关系的调节因素进行检查 疼痛和尼古丁消耗的体验差异可能会提前完成该项目。 研究和临床实践将疼痛确定为一个重要但尚未得到充分认识的发病风险因素 尼古丁消费量的增加（通过香烟和/或电子烟）。 NIDA 的既定目标是了解各种因素之间复杂的相互作用，例如合并症， 影响吸毒轨迹。17 该奖项将提供资源和受保护的时间，以进一步推动 申请人在几个关键领域的培训，包括增加对疼痛的了解和使用替代疗法 尼古丁/烟草产品以及与人口水平数据和轨迹分析相关的学习技能 完成拟议项目目标所需的培训、研讨会和合作。 否则将无法通过申请人的临床心理学研究生学习和安置获得 申请人致力于成为 NIH 资助的独立研究人员，并且 旨在获得博士后奖学金和随后的教职职位，这将使她能够追求 在快速新兴的疼痛和药物使用领域进行多学科研究的规划线。