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      Cigarette Smoking and Musculoskeletal Pain Severity Among Male and Female Afghanistan/Iraq Era Veterans

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          Abstract

          Objective

          Cigarette smoking and musculoskeletal pain are prevalent among Department of Veterans Affairs (VA) health care system users. These conditions frequently co-occur; however, there is limited empirical information specific to Afghanistan/Iraq era veterans. The present study sought to examine gender differences in the association between cigarette smoking and moderate to severe musculoskeletal pain in US veterans with Afghanistan/Iraq era service.

          Methods

          A random sample of 5,000 veterans with service after November 11, 2001, participated in a survey assessing health care needs and barriers to care. One thousand ninety veterans completed the survey assessing post-traumatic stress disorder (PTSD) symptoms, depressive symptoms, and current pain severity. Multivariate logistic regression was used to examine the association between gender, cigarette smoking status, and current moderate to severe musculoskeletal pain.

          Results

          Findings indicated a significant gender by smoking interaction on moderate/severe musculoskeletal pain, adjusting for age, self-reported race/ethnicity and weight status, combat exposure, probable PTSD, depressive symptoms, service-connected injury during deployment, and VA health care service utilization. Deconstruction of the interaction indicated that female veteran smokers, relative to female nonsmokers, had increased odds of endorsing moderate to severe musculoskeletal pain (odds ratio [OR] = 2.73, 95% confidence interval [CI] = 1.16–6.41), whereas this difference was nonsignificant for male veterans (OR = 1.03, 95% CI = 0.69–1.56).

          Conclusions

          Survey data from Operation Enduring Freedom/Operation Iraqi Freedom veterans suggest an association between current smoking, gender, and moderate to severe musculoskeletal pain. The stronger relationship between smoking and pain in women supports the need for interventional and longitudinal research that can inform gender-based risk factors for pain in veteran cigarette smokers.

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          Author and article information

          Journal
          Pain Med
          Pain Med
          painmedicine
          Pain Medicine: The Official Journal of the American Academy of Pain Medicine
          Oxford University Press
          1526-2375
          1526-4637
          September 2017
          14 March 2017
          14 March 2017
          : 18
          : 9
          : 1795-1804
          Affiliations
          [1 ]VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA
          [2 ]Durham VA Medical Center, Durham, NC, USA
          [4 ]Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
          [5 ]Center for Health Services Research in Primary Care, Durham VA Medical Center, NC, USA
          [6 ]Department of Internal Medicine, Yale University, New Haven, CT, USA
          [3 ]Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA
          [7 ]Phoenix VA Healthcare System, 650 E. Indian School Road, Phoenix, AZ, USA8
          [8 ]Department of Medicine, Duke University School of Medicine, Durham, NC, USA
          Author notes
          Correspondence to: Patrick Calhoun, PhD, Durham VA Medical Center, 508 Fulton Street Durham, NC 27705, USA. Tel: 919-286-0411, ext. 7970; Fax: 919-416-5922; E-mail: patrick.calhoun2@ 123456va.gov .
          Article
          PMC6051440 PMC6051440 6051440 pnw339
          10.1093/pm/pnw339
          6051440
          28340108
          668acfe2-0eb1-4888-8399-19e48cac84a6
          2017 American Academy of Pain Medicine. This work is written by US Government employees and is in the public domain in the US.

          This work is written by (a) US Government employee(s) and is in the public domain in the US.

          History
          Page count
          Pages: 10
          Funding
          Funded by: National Institutes of Health 10.13039/100000002
          Award ID: R01CA196304
          Categories
          REHABILITATION SECTION
          Original Research Article

          Military Veterans,Persistent Pain,Cigarette Smoking
          Military Veterans, Persistent Pain, Cigarette Smoking

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