• Marina Unrod, Ronald J Gironda, Michael E Clark, Kristi E White, Vani N Simmons, Steven K Sutton, and Thomas H Brandon.
• Health Outcomes and Behavior, H. Lee MoffittCancer Center & Research Institute, Tampa, Florida, USA; The Counseling Center, University of South Florida, Tampa, Florida, USA.
• Pain Med. 2014 Aug 1; 15 (8): 129413031294-303.

ObjectiveThe primary aim of this study was to assess smoking characteristics and cessation motivation prior to and after initiation of multidisciplinary chronic pain treatment. A secondary aim was to identify predictors of cessation motivation among smokers initiating treatment for chronic pain.DesignWe used a prospective, nonrandomized, repeated measures design.SettingThe study was conducted in a multidisciplinary specialty pain treatment program at a veterans hospital.PatientsSmokers (N = 90) referred to a multidisciplinary pain program for the treatment of chronic pain.MeasuresPatients completed questionnaires assessing pain-related and smoking-related factors prior to (baseline) and 8 weeks post (follow-up) specialty pain treatment initiation. Primary outcome measures were the Contemplation Ladder and the Stages of Change (SOC) algorithm.ResultsAt baseline, patients reported moderate levels of cessation motivation, and 69% were in the contemplation stage or higher on the SOC. Motivation to quit smoking was higher at follow-up compared with baseline on both continuous, t(89) = 2.11, P < 0.05, and stage-based, z = 3.69, P < 0.01, measures. At follow-up, participants reported greater interest in receiving cessation interventions, and 7.8% of patients had quit smoking. Pain-related predictors of motivation (e.g., pain intensity) were subsumed by more general predictors (e.g., nicotine dependence).ConclusionsPatients in this sample were more motivated to quit smoking a few weeks after, as compared with before initiating specialty pain treatment. Future research into pain-specific predictors of cessation motivation is warranted to inform the development of interventions that address pain patients' unique needs.Wiley Periodicals, Inc.

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