Pain and smoking study (PASS): A comparative effectiveness trial of smoking cessation counseling for veterans with chronic pain

Lori A. Bastian, Mary Driscoll, Eric DeRycke, Sara Edmond, Kristin Mattocks, Joe Goulet, Robert D. Kerns, Mark Lawless, Caroline Quon, Kim Selander, Jennifer Snow, Jose Casares, Megan Lee, Cynthia Brandt, Joseph Ditre, William Becker

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Smoking is associated with greater pain intensity and pain-related functional interference in people with chronic pain. Interventions that teach smokers with chronic pain how to apply adaptive coping strategies to promote both smoking cessation and pain self-management may be effective. Methods: The Pain and Smoking Study (PASS) is a randomized clinical trial of a telephone-delivered, cognitive behavioral intervention among Veterans with chronic pain who smoke cigarettes. PASS participants are randomized to a standard telephone counseling intervention that includes five sessions focusing on motivational interviewing, craving and relapse management, rewards, and nicotine replacement therapy versus the same components with the addition of a cognitive behavioral intervention for pain management. Participants are assessed at baseline, 6, and 12 months. The primary outcome is smoking cessation. Results: The 371 participants are 88% male, a median age of 60 years old (range 24–82), and smoke a median of 15 cigarettes per day. Participants are mainly white (61%), unemployed (70%), 33% had a high school degree or less, and report their overall health as “Fair” (40%) to “Poor” (11%). Overall, pain was moderately high (mean pain intensity in past week = 5.2 (Standard Deviation (SD) = 1.6) and mean pain interference = 5.5 (SD = 2.2)). Pain-related anxiety was high (mean = 47.0 (SD = 22.2)) and self-efficacy was low (mean = 3.8 (SD = 1.6)). Conclusions: PASS utilizes an innovative smoking and pain intervention to promote smoking cessation among Veterans with chronic pain. Baseline characteristics reflect a socioeconomically vulnerable population with a high burden of mental health comorbidities.

Original languageEnglish (US)
Article number100839
JournalContemporary Clinical Trials Communications
StatePublished - Sep 2021


  • Cognitive behavioral treatment
  • Pain
  • Proactive recruitment
  • Smoking cessation
  • Tobacco

ASJC Scopus subject areas

  • Pharmacology


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