Assessing the impacts of smoking cessation and resumption on back pain risk in later life

Abstract

BackgroundThis study aimed to assess the impacts of smoking cessation and resumption over 4 years on the risk of back pain at the 6‐year follow‐up among older adults in England.MethodsWe analysed 6467 men and women aged ≥50 years in the English Longitudinal Study of Aging. Self‐reported smoking status, assessed in waves 4 (2008–2009) and 6 (2012–2013), was used as exposure for the study, whereas self‐reported back pain of moderate or severe intensity, assessed in wave 7 (2014–2015), was used as the outcome. A targeted minimum loss‐based estimator was used with longitudinal modified treatment policies to adjust for baseline and time‐varying covariates.ResultsRegarding the estimation of the effects of changes in smoking status on the risk of back pain, during the follow‐up, individuals who resumed smoking within 4 years had a higher risk of back pain than those who avoided smoking for over 4 years, and the relative risk (RR) (95% confidence interval [CI]) was 1.536 (1.214–1.942). Regarding the estimation of effects of smoking cessation on the risk of back pain, smoking cessation over 4 years was associated with a significantly lower risk of back pain, as indicated by the originally observed data, and the RR (95% CI) was 0.955 (0.912–0.999).ConclusionsOlder adults who avoided smoking for over 4 years had a lower risk of back pain. However, those who resumed smoking within 4 years had a higher risk of back pain.SignificanceOlder adults who avoided smoking for over 4 years had a lower risk of back pain. However, those who resumed smoking within 4 years had a higher risk of back pain. Our study data suggest the importance of maintaining smoking cessation to reduce the risk of back pain in the older population.

Association between smoking and incident back pain: A prospective cohort study with 438 510 participants

“…Given the multi-perspective negative impacts of smoking on spinal health, we found that changes in smoking behavior, such as quitting smoking and not smoking, led to a decrease in BP risk, which is consistent with previous research [14,34], while lowering smoking volume and intensity resulted in a more significant BP risk reduction among current smokers. One potential explanation for this observation is the recovery process that occurs after prolonged nicotine consumption, in which the central nervous system undergoes a restorative phase, leading to a reduction in over-amplified pain perception following the discontinuation of nicotine exposure [35].…”