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Does smoking cessation reduce other substance use, psychiatric symptoms, and pain symptoms? Results from an emulated hypothetical randomized trial of US veterans.
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- Author(s): Ban KF;Ban KF; Rogers E; Rogers E; Khan M; Khan M; Scheidell J; Scheidell J; Charles D; Charles D; Bryant KJ; Bryant KJ; Justice AC; Justice AC; Justice AC; Braithwaite RS; Braithwaite RS; Caniglia EC; Caniglia EC
- Source:
PloS one [PLoS One] 2024 Jul 03; Vol. 19 (7), pp. e0298576. Date of Electronic Publication: 2024 Jul 03 (Print Publication: 2024).- Publication Type:
Journal Article; Randomized Controlled Trial- Language:
English - Source:
- Additional Information
- Source: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
- Publication Information: Original Publication: San Francisco, CA : Public Library of Science
- Subject Terms: Smoking Cessation*/psychology ; Smoking Cessation*/methods ; Veterans*/psychology ; Pain* ; Substance-Related Disorders*/epidemiology ; Substance-Related Disorders*/psychology; Humans ; Male ; Female ; Middle Aged ; United States/epidemiology ; Adult ; Aged ; Depression/epidemiology ; Anxiety/epidemiology ; Longitudinal Studies ; Cigarette Smoking/epidemiology
- Abstract: Background: Quitting smoking may lead to improvement in substance use, psychiatric symptoms, and pain, especially among high-risk populations who are more likely to experience comorbid conditions. However, causal inferences regarding smoking cessation and its subsequent benefits have been limited.
Methods: We emulated a hypothetical open-label randomized control trial of smoking cessation using longitudinal observational data of HIV-positive and HIV-negative US veterans from 2003-2015 in the Veterans Aging Cohort Study. We followed individuals from the first time they self-reported current cigarette smoking (baseline). We categorized participants as quitters or non-quitters at the first follow-up visit (approximately 1 year after baseline). Using inverse probability weighting to adjust for confounding and selection bias, we estimated odds ratios for improvement of co-occurring conditions (unhealthy alcohol use, cannabis use, illicit opioid use, cocaine use, depressive symptoms, anxiety symptoms, and pain symptoms) at second follow-up (approximately 2 years after baseline) for those who quit smoking compared to those who did not, among individuals who had the condition at baseline.
Results: Of 4,165 eligible individuals (i.e., current smokers at baseline), 419 reported no current smoking and 2,330 reported current smoking at the first follow-up. Adjusted odds ratios (95% confidence intervals) for associations between quitting smoking and improvement of each condition at second follow-up were: 2.10 (1.01, 4.35) for unhealthy alcohol use, 1.75 (1.00, 3.06) for cannabis use, 1.10 (0.58, 2.08) for illicit opioid use, and 2.25 (1.20, 4.24) for cocaine use, 0.78 (0.44, 1.38) for depressive symptoms, 0.93 (0.58, 1.49) for anxiety symptoms, and 1.31 (0.84, 2.06) for pain symptoms.
Conclusions: While a causal interpretation of our findings may not be warranted, we found evidence for decreased substance use among veterans who quit cigarette smoking but none for the resolution of psychiatric conditions or pain symptoms. Findings suggest the need for additional resources combined with smoking cessation to reduce psychiatric and pain symptoms for high-risk populations.
Competing Interests: The authors have declared that no competing interests exist.
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- Publication Date: 20240705
- Accession Number: PMC11221691
- Accession Number: 10.1371/journal.pone.0298576
- Accession Number: 38959263
- Source:
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