Tobacco use is well known to be the single most significant risk factor pertaining to cancer cases, and the relationship between smoking and cancer is evident. In addition, in a new study it is revealed that for those persons with cancer types stages one through five who continue to smoke after being diagnosed, no matter what type of cancer is progressing, experience higher levels of pain severity and discomfort.

Joseph W. Ditre, PhD, Department of Psychology, Texas A&M University explains the research that is published in the January 2011 edition of Pain:

    “To elucidate important relations between pain and smoking among persons with cancer, and to identify prospective targets for intervention, it is necessary to build upon past findings by examining smoking status and pain reporting in greater detail, across a wider range of cancer patients, and with regard to potential benefits of quitting smoking. Specifically, we hypothesized that, among patients with diverse cancer diagnoses, current smokers would report greater pain, pain interference, and pain-related distress than former smokers and/or never smokers. We also planned to examine associations between pain and other smoking variables (e.g., number of years since quitting) in an exploratory fashion.”

The study analyzed 224 patients diagnosed with various forms of malignant cancer. Measures of pain severity, pain-related distress, and pain-related interference, as well as a demographics questionnaire were administered to the group. The degree of bodily pain was measured on a scale from 1 to 6, and measure of how much this pain disrupted their daily routines was measured from 1 to 5.

Current smokers experienced more severe pain than never smokers, and also reported more interference from pain than either never smokers or former smokers. Among former smokers, there was an inverse relation between pain and the number of years since quitting, suggesting that quitting smoking may reduce pain over time.

Cancer is a leading cause of death worldwide. The disease accounted for 7.4 million fatalities or around 13% of all deaths worldwide in 2004. Cancer of the lungs accounts for approximately 1.3 million deaths each year followed by stomach cancer which claims around 850, 000 persons annually.

Smoking causes many other types of cancer, including cancers of the throat, mouth, nasal cavity, esophagus, stomach, pancreas, kidney, bladder, and cervix, and acute myeloid leukemia. In addition, people who smoke are up to six times more likely to suffer a heart attack than nonsmokers, and the risk increases with the number of cigarettes smoked. Smoking also causes most cases of chronic lung disease.

In 2009, approximately 20.6 percent of U.S. adults were cigarette smokers and nearly 20 percent of high school students smoke cigarettes.

Lori Bastian, MD, Durham VA Medical Center and Department of Internal Medicine, Duke University points out the importance of doctors insisting their cancer patients refrain from smoking:

    “Clinicians must do more to assist cancer patients to quit smoking after their diagnosis. The major strength of this study is the diverse types of cancer and stage of disease. Although more research is needed to understand the mechanisms that relate nicotine to pain, physicians should aggressively promote smoking cessation among cancer patients. Preliminary findings suggest that smoking cessation will improve the overall treatment response and quality of life.”

The article is “Associations between pain and current smoking status among cancer patients” by Joseph W. Ditre, Brian D. Gonzalez, Vani N. Simmons, Leigh Anne Faul, Thomas H. Brandon, and Paul B. Jacobsen (DOI: 10.1016/j.pain.2010.09.001). The accompanying commentary is “Pain and smoking among cancer patients: The relationship is complex but the clinical implication is clear” by Lori Bastian (DOI: 10.1016/j.pain.2010.10.023). Both the article and its commentary appear in PAIN, Volume 152, Issue 1 (January 2011) published by Elsevier.

Written by Sy Kraft, B.A.