Spinal health and smoking.

Spine care is a growing concern for health care in the United States. Although the etiology of spinal pain can be multifactorial, reducing preventable causes would have a significant impact on the morbidity and lost productivity that parallels spinal disease. Numerous studies have demonstrated significant direct relationships between smoking and back pain. Other studies identify smoking as a strong predictor for slow recovery or pseudoarthrosis, the failure of solid fusions, following spinal surgery. The mechanisms by which these occur may be multi-faceted, from decreased exercise among smokers to disruption of cellular metabolism in the vertebral bodies and discs.