Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 2017 05 03() doi 10.1093/ntr/ntx094
The present study investigated the associations between smoking, pain, and opioid consumption in the three months after major surgery in patients seen by the Transitional Pain Service. Current smoking status and lifetime pack years were expected to be related to higher pain intensity, more opioid use, and poorer opioid weaning after surgery.
239 patients reported smoking status in their pre-surgical assessment (62 smokers, 92 past smokers, and 85 never smokers). Pain and daily opioid use were assessed in hospital before post-surgical discharge, at first outpatient visit (median of one month post-surgery), and at last outpatient visit (median of 3 months post-surgery). Pain was measured using numeric rating scale. Morphine equivalent daily opioid doses were calculated for each patient.
Current smokers reported significantly higher pain intensity (p < 0.05) at one month post-surgery than never smokers and past smokers. Decline in opioid consumption differed significantly by smoking status, with both current and past smokers reporting a less than expected decline in daily opioid consumption (p < 0.05) at 3 months. Decline in opioid consumption was also related to pack years, with those reporting higher pack years having a less than expected decline in daily opioid consumption at 3 months (p < 0.05). Conclusions
Smoking status may be an important modifiable risk factor for pain intensity and opioid use after surgery.
In a population with complex post-surgical pain, smoking was associated with greater pain intensity at one month after major surgery and less opioid weaning three months after surgery. Smoking may be an important modifiable risk factor for pain intensity and opioid use after surgery.