Smoking is a risk factor for worse cognitive function, symptom severity, quality of life, and increased depression and anxiety in patients with fibromyalgia, according to a study analyzing patient-reported outcomes.
The results were displayed at November’s 17th Annual Pain Medicine Meeting in San Antonio, Texas, in a poster titled “Tobacco Use in Fibromyalgia Is Associated with Cognitive Dysfunction: A Prospective Cohort Study.“
Although fibromyalgia is a prevalent condition, thought to affect more than five million adults in the U.S., there is little data concerning the risk factors that predispose patients to worse cognitive symptoms.
While chronic and widespread pain is a hallmark of the disease, cognitive impairment — the so-called “brain fog” or “fibro fog” — is also common and sometimes even more disabling than pain.
Studies report that most fibromyalgia patients (50-80%) experience memory problems, mental confusion, and trouble concentrating.
To better understand whether some environmental factors, specifically smoking, might affect fibromyalgia outcomes, researchers with the Mayo Clinic in Rochester, Minnesota, conducted a study to explore the link between smoking and cognitive function, symptom severity, quality of life, fatigue and mental disorders in fibromyalgia patients.
Researchers surveyed 668 patients with fibromyalgia referred to the Mayo Clinic. They found that 14.07 percent of patients reported they were smokers, and this smoker population tended to be younger (average of 43 versus 47.92 years) and have a lower education level, compared with nonsmokers.
Cognitive function, the primary outcome of interest, was measured using the multiple-ability self-report questionnaire (MASQ). Other patient-perceived outcomes were measured using surveys, including symptom severity (FIQ-R), quality of life (SF-36), fatigue (MFI-20), sleep difficulties (MOS-sleep scale), anxiety (GAD-7), and depression (PHQ-9).
After adjusting the data — controlling for possible biases — for age, gender, body mass index, marital status, and education level, the analysis showed that patients who smoked were more likely to have worse cognitive function.
These differences were reflected in significantly lower total MASQ scores for patients who smoked; specific scales within the survey also identified significantly worse language, verbal memory, visual-spatial memory, and attention ability among smokers.
Patients’ answers to the secondary surveys also showed that smoking is a risk factor for greater symptom severity and worse quality of life related to physical pain and mental status, and worse sleep problems, anxiety and depression.