Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C

Lynch, Shaina M.; Wilson, Sarah M.; DeRycke, Eric; Driscoll, Mary; Becker, William C.; Goulet, Joseph L.; Kerns, Robert D.; Mattocks, Kristin M.; Brandt, Cynthia; Bathulapalli, Harini; Skanderson, Melissa; Haskell, Sally G.; Bastian, Lori A.

doi:10.1093/pm/pny146

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Additionally, very little research has explored correlates of cigarette smoking among people with HCV. These available studies have identified older age, alcohol use, use of illicit substances, and experiencing pain [15,16] as correlates of cigarette smoking among HCV patients.…”

Section: Introductionmentioning

confidence: 99%

Factors and HCV treatment outcomes associated with smoking among people who inject drugs on opioid agonist treatment: secondary analysis of the PREVAIL randomized clinical trial

et al. 2020

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Background Cigarette smoking has emerged as a leading cause of mortality among people with hepatitis C virus (HCV). People who inject drugs (PWID) represent the largest group of adults infected with HCV in the US. However, cigarette smoking remains virtually unexplored among this population. This study aimed at (1) determining prevalence and correlates of cigarette smoking among HCV-infected PWID enrolled in opiate agonist treatment programs; (2) exploring the association of smoking with HCV treatment outcomes including adherence, treatment completion and sustained virologic response (SVR); and 3) exploring whether cigarette smoking decreased after HCV treatment. Methods Participants were 150 HCV-infected PWID enrolled in a randomized clinical trial primarily designed to test three intensive models of HCV care. Assessments included sociodemographics, presence of chronic health and psychiatric comorbidities, prior and current drug use, quality of life, and HCV treatment outcomes. Results The majority of the patients (84%) were current cigarette smokers at baseline. There was a high prevalence of psychiatric and medical comorbidities in the overall sample of PWID. Alcohol and cocaine use were identified as correlates of cigarette smoking. Smoking status did not influence HCV treatment outcomes including adherence, treatment completion and SVR. HCV treatment was not associated with decreased cigarette smoking. Conclusions The present study showed high prevalence of cigarette smoking among this population as well as identified correlates of smoking, namely alcohol and cocaine use. Cigarette smoking was not associated with HCV treatment outcomes. Given the detrimental effects that cigarette smoking and other co-occurring, substance use behaviors have on HCV-infected individuals’ health, it is imperative that clinicians treating HCV also target smoking, especially among PWID. The high prevalence of cigarette smoking among PWID will contribute to growing morbidity and mortality among this population even if cured of HCV. Tailored smoking cessation interventions for PWID along with HCV treatment may need to be put into clinical practice. Trial registration NCT01857245. Registered May 20, 2013.

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Section: Introductionmentioning

confidence: 99%

Factors and HCV treatment outcomes associated with smoking among people who inject drugs on opioid agonist treatment: secondary analysis of the PREVAIL randomized clinical trial

et al. 2020

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Understanding Pain and Pain Treatment for Veterans: Responding to the Federal Pain Research Strategy

et al. 2018

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Substances and substance combinations among accidental substance-related acute toxicity deaths (AATDs) in Canada from 2016 to 2017

Ahmad,

Kakkar,

Rotondo

et al. 2024

Preprint

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Background Canada has seen a rise in substance-related accidental acute toxicity deaths (AATDs) in recent years. Research indicates that fentanyl opioids, non-fentanyl opioids, and stimulants are classes of concern and that multidrug AATDs have increased. However, there is limited information regarding the specific substances involved. This study aims to identify the substances and substance combinations as well as substance classes and substance class combinations most often involved in AATDs across Canada between 2016 and 2017. It also examines variations in substances by year and across sociodemographic, socioeconomic, and geographic factors. Methods Data were abstracted from the coroner and medical examiner files of all AATDs that occurred across Canada between 2016 and 2017. Top substances and classes detected in or contributing to AATDs were identified based on toxicology reports and cause of death statements. AATDs were stratified by year of death, age, sex, residence community type, neighbourhood income quintile, and province/region to understand variations in the substances contributing to AATDs. Combinations of substances and classes contributing to death were examined with UpSet plots and trends of select substances were visualized over time with ribbon charts. An algorithm was developed to report the source and origin of the substances based on prescription history and scene evidence. Results Fentanyl, cocaine, alcohol, and methamphetamine were the top substances contributing to the 7,902 AATDs identified between 2016 and 2017 in Canada. While stimulants and opioids were the most common substance classes contributing to AATDs, other classes, including benzodiazepines and acetaminophen also emerged as classes among the top contributors. Between 2016 and 2017, the proportion of AATDs attributable to diacetylmorphine (heroin) per quarter decreased while the proportion of AATDs attributable to carfentanil per quarter increased. AATDs involving more than one substance occurred across all sociodemographic, socioeconomic, and geographic groups. Substances contributing to AATDs more commonly originated from non-pharmaceutical sources than from pharmaceutical sources. Conclusions and impacts: Specific substances and substance combinations contributing to deaths vary over time and geographic areas. Opioids and stimulants are both detected in and contribute to a majority of AATDs, but the substance-related acute toxicity death crisis is complex and attributable to many substance classes. Understanding these differences will allow for targeted substance-related policies, prevention, and harm reduction efforts.

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Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C

Abstract: We found that current smoking is more strongly linked to pain intensity among veterans with HCV. Further investigations are needed to explore the impact of smoking status on pain and to promote smoking cessation and pain management in veterans with HCV.

Cited by 3 publications

References 31 publications

Factors and HCV treatment outcomes associated with smoking among people who inject drugs on opioid agonist treatment: secondary analysis of the PREVAIL randomized clinical trial

Factors and HCV treatment outcomes associated with smoking among people who inject drugs on opioid agonist treatment: secondary analysis of the PREVAIL randomized clinical trial

Understanding Pain and Pain Treatment for Veterans: Responding to the Federal Pain Research Strategy

Substances and substance combinations among accidental substance-related acute toxicity deaths (AATDs) in Canada from 2016 to 2017

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