BACKGROUND The harms associated with prescription opioid abuse have become a public health crisis. There is a need for evidence-based objective markers of the risk of opioid use disorder (OUD) in patients with pain receiving opioid treatment. The objective of this study was to evaluate the independent association of tobacco use and OUD in patients with chronic non-cancer pain. METHODS This cross-sectional naturalistic study evaluated 798 adults ≥ 18 years with chronic non-cancer pain treated with long-term opioid therapy (≥ 6 months) who either developed an OUD (cases, n = 216) or displayed no evidence of an OUD (controls, n = 582). The primary outcome was presence of OUD. In addition to current self-reported tobacco use (primary predictor), covariates included demographics, pain severity, and psychiatric history. Data were collected between November 2012 and September 2018. RESULTS Current tobacco use independently was strongly associated with OUD [odds ratio (OR) 14.0, 95 % confidence interval (CI) 9.5-20.6, p < 0.001], and this association remained significant after adjusting for other risk factors [adjusted odds ratio (aOR) 7.6, 95 % CI 4.8-12.2, p < 0.001]. Other factors associated independently with development of OUD included age, marital status, financial status, education and pain severity. CONCLUSIONS AND RELEVANCE Current tobacco use is significantly associated with OUD in patients with chronic pain receiving long-term opioid therapy.

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在欧洲血统的慢性非癌性疼痛患者中，吸烟与阿片类药物使用障碍的独立关联。

背景技术与处方阿片类药物滥用相关的危害已经成为公共卫生危机。需要在接受阿片类药物治疗的疼痛患者中使用基于证据的客观标志物来评估阿片类药物使用障碍（OUD）的风险。这项研究的目的是评估慢性非癌性疼痛患者中烟草使用与OUD的独立关联。方法这项横断面的自然研究评估了798名≥18岁，经长期阿片类药物治疗（≥6个月）治疗的慢性非癌性疼痛的成年人，这些成年人发生了OUD（病例，n = 216）或未显示任何OUD证据。 （控制项，n = 582）。主要结果是存在OUD。除了当前自我报告的烟草使用（主要预测指标）外，协变量还包括人口统计学，疼痛严重程度和精神病史。结果在2012年11月至2018年9月之间收集。结果当前的烟草独立使用与OUD密切相关[比值比（OR）14.0，95％置信区间（CI）9.5-20.6，p <0.001]，并且这种关联在显着增加之后调整其他风险因素[调整后的优势比（aOR）7.6，95％CI 4.8-12.2，p <0.001]。与OUD的发展独立相关的其他因素包括年龄，婚姻状况，财务状况，教育程度和疼痛程度。结论和相关性在接受长期阿片类药物治疗的慢性疼痛患者中，当前的烟草使用与OUD显着相关。并在调整了其他风险因素后仍保持显着相关性[校正比值比（aOR）7.6，95％CI 4.8-12.2，p <0.001]。与OUD的发展独立相关的其他因素包括年龄，婚姻状况，财务状况，教育程度和疼痛程度。结论和相关性在接受长期阿片类药物治疗的慢性疼痛患者中，当前的烟草使用与OUD显着相关。并且在调整了其他风险因素后，这种关联仍然很显着[校正比值比（aOR）7.6，95％CI 4.8-12.2，p <0.001]。与OUD的发展独立相关的其他因素包括年龄，婚姻状况，财务状况，教育程度和疼痛程度。结论和相关性在接受长期阿片类药物治疗的慢性疼痛患者中，当前的烟草使用与OUD显着相关。