Does a history of depression actually mediate smoking-related pain? Findings from a cross-sectional general population-based study.

van Hecke, O.; Torrance, N.; Cochrane, L.; Cavanagh, J.; Donnan, P.T.; Padmanabhan, S.; Porteous, D.J.; Hocking, L.; Smith, B.H.

Abstract

Background: Smokers report more pain and worse functioning. The evidence from pain clinics suggests that depression affects this relationship: The association between smoking and chronic pain is weakened when controlling for depression. This study explored the relationship between smoking, pain and depression in a large general population-based cohort (Generation Scotland: Scottish Family Health Study). Methods: Chronic pain measures (intensity, disability), self-reported smoking status and a history of major depressive disorder (MDD) were analysed. A multivariate analysis of covariance determined whether smoking status was associated with both pain measures and a history of depressive illness. Using a statistical mediation model any mediating effect of depression on the relationship between smoking and chronic pain was sought. Results: Of all 24,024 participants, 30% (n=7162) reported any chronic pain. Within this chronic pain group, 16% (n=1158) had a history of MDD; 7108 had valid smoking data: 20% (n=1408) were current smokers, 33% (n=2351) former and 47% (n=3349) never smokers. Current smokers demonstrated higher pain intensity and pain-related disability scores compared with former and non-smokers (p [less than] 0.001 for all analyses). From the mediation model, the effect on pain intensity decreased (p [less than] 0.001), indicating that the relationship between smoking and a history of depression contributes significantly to the effect of smoking on pain intensity. When applied to smoking-related pain disability, there was no mediation effect. Conclusions: In contrast to smokers treated in pain clinics, a history of MDD mediated the relationship between smoking and pain intensity, but not pain-related disability in smokers in the community.

Citation

VAN HECKE, O., TORRANCE, N., COCHRANE, L., CAVANAGH, J., DONNAN, P.T., PADMANABHAN, S., PORTEOUS, D.J., HOCKING, L. and SMITH, B.H. 2014. Does a history of depression actually mediate smoking-related pain? Findings from a cross-sectional general population-based study. European journal of pain [online], 18(9), pages 1223-1230. Available from: https://doi.org/10.1002/j.1532-2149.2014.00470.x

• Journal Article Type: Article
• Acceptance Date: Jan 24, 2014
• Online Publication Date: Feb 27, 2014
• Publication Date: Oct 31, 2014
• Deposit Date: Apr 2, 2020
• Publicly Available Date: Apr 2, 2020
• Journal: European journal of pain
• Print ISSN: 1090-3801
• Electronic ISSN: 1532-2149
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 9
• Pages: 1223-1230
• DOI: https://doi.org/10.1002/j.1532-2149.2014.00470.x
• Keywords: Smokers; Pain; Depression; Chronic pain measures; Major depressive disorder
• Public URL: https://rgu-repository.worktribe.com/output/820077