Date of Award

June 2017

Degree Type


Degree Name

Doctor of Philosophy (PhD)




Joseph W. Ditre


Cessation, Chronic Pain, Motivation, Pain, Smoking, Tobacco

Subject Categories

Social and Behavioral Sciences


Tobacco smokers are at increased risk for the development and progression of chronic pain, and smokers with co-occurring pain tend to report greater difficulty and less confidence in quitting. Smokers in pain face unique cessation challenges and may benefit from tailored interventions that address smoking in the context of pain. This pilot study is the first to test the effects of an intervention tailored for smokers with co-occurring pain on motivation to quit and engage cessation treatment. Smokers with chronic pain (N = 76, 57.9% Female, 52.6% White, Mcpd = 17.64) were randomly assigned to either the tailored or control intervention. Results indicated that the tailored intervention (vs. control) increased knowledge of pain-smoking interrelations, motivation to quit smoking, desire to quit, and expected success in quitting (ps < .01). Participants who received the tailored intervention were also more likely to accept information about available smoking cessation treatments (p = .015), and to report interest (p = .006) and intention to engage treatment in the next month (p = .003). Effects of the tailored intervention on desire to quit and willingness to learn about cessation treatments were mediated by increased knowledge of pain-smoking interrelations. At one-month follow-up, treatment gains in knowledge of pain-smoking interrelations were maintained (p = .009), and participants who received the tailored intervention were more likely to report having subsequently talked to their doctor about smoking (p = .034). These data support the notion that smokers with co-occurring pain may benefit from interventions that have been tailored to address tobacco smoking in the context of pain. Collectively, these findings suggest that smokers with co-occurring pain may become more motivated to quit and engage cessation treatment as they become aware of how continued smoking may be incongruent with their desired pain outcomes.


Open Access