The American Academy of Pain Medicine      Annual Meeting Home Page     
24th Annual Meeting
February 13-16, 2008
Orlando, FL

2006 American Academy of Pain Medicine

Thursday, February 14, 2008

Smoking and Neuropathic Pain

Todd G. Call, MD, Toby N. Weingarten, MD, James C. Watson, MD, W. Michael Hooten, MD, Peter C. Wollan, PhD, Lee J. Melton, MD, and Barbara P. Yawn, MD. Mayo Clinic College of Medicine, Rochester, MN, USA

Introduction: This study aims to determine the percentage of community subjects with chronic neuropathic pain that smoke.

Methods: Following IRB approval, subjects were recruited from a large population based study to assess the prevalence of chronic pain in adults.1 A subset of subjects with a positive S-LANSS score2, self-reported neuropathic pain, or had select ICD-9-CM codes associated with neuropathic pain identified upon chart review3, underwent clinical assessment to determine the presence of neuropathic pain. Subjects reported current smoking status.

Results: 205 subjects participated. The percentage of subjects confirmed to have neuropathic pain by clinical assessment that smoked was 21% compared to 13% in the entire sample (p = 0.009). The percentages of subjects that smoked varied by positivity on screening tests for neuropathic pain: 18% for a positive S-LANSS score (p=0.09), 12% with self reported neuropathic pain (p = 0.99), and 8% of those with select ICD-9-CM codes (p = 0.56).

Conclusions: Smoking was twice as common (62% versus 33%) in subjects that were diagnosed by clinical assessment as having neuropathic versus nociceptive pain. Similar differences were not found among those positive and negative on screening assessment for neuropathic pain. The possible physiological relationship between smoking and development of chronic neuropathic pain deserves further evaluation.

References: 1. Watkins E. et al. Prevalence of pain in a community population. (2007) Pain Medicine. In Press.

2. Bennett, M.I. et al. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. (2005) J Pain 6: 149-158.

3. Berger, A., Dukes, A.M., Oster, G., Clinical Characteristics and Economic Costs of Patients with Painful Neuropathic Disorders, (2004) J Pain 5: 143-149.
Funding: This work was supported by an unrestricted grant from AstraZeneca and NIH grant AR30852.

Todd G. Call, MD
Nothing to disclose.