• Michael J Zvolensky, Andrew H Rogers, Lorra Garey, Joseph W Ditre, Justin M Shepherd, Andres G Viana, Brooke Y Kauffman, and Michael Businelle.
• Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA. mjzvolen@central.uh.edu.
• Int J Behav Med. 2020 Dec 1; 27 (6): 668-676.

BackgroundThe additive effect of experiencing chronic pain in the context of nicotine addiction places smokers with chronic pain at elevated risk for experiencing physical and mental health problems. Isolating factors that explain linkages between pain and health-related outcomes among smokers with chronic pain is an important next step. Therefore, the current study examined the explanatory role of anxiety sensitivity in relations between pain intensity and current opioid misuse, severity of opioid dependence, tobacco-related problems, and anxiety/depressive symptoms.MethodParticipants were 187 (Mage = 39.02, SD = 9.94, 74.9% female) daily smokers with chronic pain who completed a battery of self-report measures on pain experience, anxiety sensitivity, tobacco and opioid use, and anxiety/depression symptoms. Indirect effect analyses were conducted to examine anxiety sensitivity as a mediator of the relations between pain intensity and health-related outcomes.ResultsA significant indirect effect emerged for pain intensity, through anxiety sensitivity, on opioid misuse (ab = 0.83, SE = 0.24, 95% CI [0.39, 1.34], CSE = 0.17), severity of opioid dependence (ab = 0.17, SE = 0.05, 95% CI [0.08, 0.26], CSE = 0.16), tobacco use problems (ab = 0.16, SE = 0.06, 95% CI [0.07, 0.28], CSE = 0.11), and anxiety/depressive symptoms (ab = 0.20, SE = 0.06, 95% CI [0.10, 0.31], CSE = 0.19).ConclusionThe current investigation highlights the potential importance of anxiety sensitivity in terms of the experience of pain with severity of substance use and anxiety/depressive symptoms among smokers with chronic pain.

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