Is Smoking a Risk Factor for Low Back Pain in Adolescents?: A Prospective Cohort Study

Department of Physical and Rehabilitation Medicine, Oulu University Hospital, Oulu, Finland.
Spine (Impact Factor: 2.3). 04/2008; 33(5):527-32. DOI: 10.1097/BRS.0b013e3181657d3c
Source: PubMed


A prospective cohort study in adolescents.
To evaluate whether smoking in adolescence is a risk factor of low back pain (LBP) among young adults.
Smoking has been found to associate with LBP among adults. Longitudinal studies performed in adolescents are few.
The children belonging to the northern Finland Birth Cohort 1986 were examined at birth and at 16 years of age and followed up by a postal questionnaire at the age of approximately 18 years. The primary outcome was LBP during the past 6-month period. Incident cases reported LBP at 18 but not at 16 years. Persistent cases reported pain at both time points. Logistic regression analysis was used to evaluate the effect of smoking exposure on any LBP in both genders separately and multinomial regression analysis was used to evaluate the effect on the severity of LBP (No LBP, "Reporting LBP," "Consultation for LBP") in the total population. Parents' socioeconomic status, physical activity, body mass index, and depressive mood were used as confounders in the analyses.
Regular smoking at 16 years was associated with persistent LBP in girls (OR: 2.52; 95% CI: 1.40-4.53). Daily smoking of over 9 cigarettes at 16 was associated with persistent LBP (2.57; 1.03-6.46) and predicted incident pain in girls (2.80; 1.11-7.09). Pack-years of smoking were associated with incident and persistent LBP in the girls with an exposure-response relationship, whereas these associations were inconsistent in the boys. Pack-years of smoking at 18 years showed an exposure-response relationship with persistent Consultation for LBP, which was strongest in those with over 1.5 pack-years of exposure (5.82; 1.39-24.42).
Regular smoking in adolescence was associated with LBP in young adults. Pack-years of smoking showed an exposure-response relationship among girls.

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    • "“Have you ever smoked regularly in your life?” and “How much do you currently smoke? [10]. On the basis of the responses, the participants were divided into three groups: (1) non-smokers, (2) 0.1–1.0 "
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    ABSTRACT: Background Adolescent’psychosocial problems associate with unhealthy behaviors, but data on co-occurring patterns is sparse. We investigated 1) whether adolescents could be categorized into meaningful subgroups with respect to psychosocial and lifestyle factors, 2) whether the prevalence of physical inactivity, overweight and smoking vary within the subgroups and 3) whether these unhealthy behaviors persist in a two-year follow-up. Methods The study was based on a subgroup of the 1986 Northern Finland Birth Cohort, which consisted of adolescents who replied to a postal questionnaire at 16 years (n = 6792) and a subgroup of this sample at 18 years (n = 1552). Latent class analysis (LCA) was performed to establish clusters at 16 years. Results Smoking co-existed with emotional and behavioral problems in both genders. Boys with the most inactive lifestyle slept poorly, whereas multiple problems co-occurred among girls. Those with a high body mass index (BMI) separated as groups of their own. Different combinations of adverse lifestyle and emotional and behavioral problems were relatively common in both sexes as only 51% of boys and 67% of girls belonged to the reference cluster with low probability for these findings. Physical inactivity, high BMI and smoking tended to persist over the two-year follow-up. Conclusions It seems that lifestyle and psychosocial factors divide adolescents into distinct subgroups in which unhealthy lifestyle patterns remain between the ages of 16 and 18. This may indicate problems in other life areas and expose them to an increased risk of future health problems.
    BMC Public Health 06/2014; 14(1):542. DOI:10.1186/1471-2458-14-542 · 2.26 Impact Factor
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    • "A variety of individual and environmental risk factors have been reported to be associated with LBP (Feldman et al., 2002; Picavet and Schuit, 2003; WHO, 2003; Jones et al., 2005; Hestbaek et al., 2006c; Mikkonen et al., 2008; Miranda et al., 2008). Unfortunately, these factors (for example genetics, smoking) do not appear to be strongly associated with the prevalence of the condition. "
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    ABSTRACT: BACKGROUND: Alcohol intake has been widely reported as a risk factor for low back pain (LBP), however, the literature is inconclusive about this association. OBJECTIVES: To determine, in a systematic review, the relationship between alcohol intake and LBP. METHODS: A search was conducted in CINAHL, LILACS, Medline, National Research Register and Web of Science to identify studies that investigated the association between alcohol intake and LBP. Quantitative results and its estimators were extracted. When possible, meta-analyses were performed using a random effects model. RESULTS: Twenty-six studies were included in this review. Twenty-three studies were retrospective cohorts, two were case-controls, and one employed a longitudinal design. Pooled results from nine studies (two case-controls and seven retrospective cohorts) showed that alcohol consumption is slightly associated with LBP (OR: 1.3; 95% CI: 1.1-1.5). This association appears to be present in studies investigating alcohol as an abuse dependence substance in chronic LBP. Remaining individual studies tended to report no statistical significant association. No dose-response relationship was identified. Only one longitudinal study was identified and even though alcohol consumption was found to be negatively associated with a future episode of LBP (OR: 0.7; 95% CI: 0.5-0.9) this association lost significance for future incidence of LBP in people with no LBP at baseline. CONCLUSIONS: Alcohol consumption appears to be associated with complex and chronic LBP only and in people with alcohol consumption dependence. Clinicians in the musculoskeletal field could use this information to design educational strategies for this population.
    Manual therapy 11/2012; 18(3). DOI:10.1016/j.math.2012.10.007 · 1.71 Impact Factor
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    • "The result will be a short-term increase in muscle contractions which can cause fatigue and pain.8,9 Similar to the research conducted by Feldman et al.,10 Ueno et al.,11 Leboeuf-Yde et al.,12 and Mikkonen et al.,13 in the present study, pain was most common in the lower back (31.25%). Ueno et al. reported the prevalence of lower back pain to be 53.2% "
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    ABSTRACT: The rising trend of smoking cigarettes, especially among the youth, has become a great concern in Iranian society. Not only does smoking cigarettes harm one financially, but also it will cause immense damage to the smoker as well as the society. This paper investigated the prevalence of musculoskeletal pain and the factors affecting it in young smokers. The research has been conducted on 400 men smokers aged 18-30 studying at Shiraz University of Medical Sciences. Data was collected through a questionnaire containing information about age, history and amount of smoking, existence of pain and its severity according to the visual analog scale (VAS). The subjects were randomly selected while making sure the proportion of subjects from each department was appropriate. The subjects were smokers for more than two years and smoked more than five cigarettes a day. Data was analyzed by analysis of variance (ANOVA) and the least significant difference (LSD) test. Among all studied subjects, 129 (32.25%) suffered from musculoskeletal pain. Most of the subjects (31.25%) had pain in their backs. The relationship between the duration of smoking and musculoskeletal pain, as well as that between the number of cigarettes smoked per day and the pain, was direct and significant. However, no significant relationship was found between age and pain. The occurrence of musculoskeletal pain in male students was relatively high. This fact can bring irrecoverable damages to the society and would put its health at risk. It also decreases the socioeconomic improvements.
    03/2011; 3(3-4):125-9.
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