Perceived Pain and Smoking Interrelations Among Veterans with Chronic Pain Enrolled in a Smoking Cessation Trial

Megan Lee, Lori A. Bastian, Lisa Larowe, Eric C. Derycke, Mark Relyea, William C. Becker, Joseph W. Ditre

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: The Pain and Smoking Inventory (PSI) measures patients' perceived interrelations of their pain and smoking behavior, and it comprises three conceptually distinct domains: smoking to cope with pain (PSI-Cope), pain as a motivator of smoking (PSI-Motivate), and pain as a barrier to cessation (PSI-Barrier). Associations between PSI scores and pain interference and self-efficacy to quit smoking, two measures that can affect cessation outcomes, remain unclear. Methods: We conducted a secondary analysis of baseline data from 371 veterans with chronic pain (88% male, Medianage=60) enrolled in a randomized smoking cessation trial. We used sequential multivariate regression models to examine associations between the three PSI domains and pain interference / self-efficacy. Results: Of 371 veterans who completed baseline surveys, 88% were male, with a median age of 60 years. PSI-Motivate scores were positively associated with pain interference (beta [B]: 0.18, 95% confidence interval [CI]: 0.02 to 0.34). PSI-Barrier subscores were negatively associated with self-efficacy (B: -0.23, 95% CI: -0.36 to -0.10). Conclusion: Findings suggest that individuals who hold maladaptive perceptions of pain-smoking interrelations could be more likely to endorse higher pain interference and lower self-efficacy - two established predictors of cessation outcomes. Moreover, each PSI subscale demonstrated unique relationships with the dependent variables, and our results provided support for a three-factor structure. These findings further demonstrate that the PSI comprises three conceptually and empirically distinct domains; future research should evaluate the clinical utility of assessing each domain in relation to cessation outcomes.

Original languageEnglish (US)
Pages (from-to)1820-1827
Number of pages8
JournalPain Medicine (United States)
Issue number11
StatePublished - Nov 1 2022


  • Pain
  • Pain and Smoking Inventory
  • Self-Efficacy
  • Smoking Cessation
  • Tobacco

ASJC Scopus subject areas

  • General Medicine


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