title: Smoking and chronic back pain: analyses of the German Telephone Health Survey 2003.
abstract: BACKGROUND
  Smoking represents the greatest avoidable risk for a large number of serious diseases. The goal of the present study was to investigate the connection between tobacco consumption and back pain, as such a link has yet to be clearly established.
  
  
  METHODS
  The analysis was based on the public use file of the German Telephone Health Survey 2003 (n = 8318), carried out by the Robert Koch Institute, Berlin. After exclusion of invalid cases, data on 7271 persons (total model) and 1998 persons (smoker model) were analyzed.
  
  
  RESULTS
  Multivariate data analysis clearly shows that not only daily smokers (OR 1.45, 95% CI 1.13 to 1.85) but also former smokers (OR 1.65, 95% CI 1.32 to 2.07) have a significantly higher chance of suffering from chronic back pain than non-smokers. Number of smoking years is the factor most significantly correlated with chronic back pain, while starting age and amount of tobacco consumed have no impact.
  
  
  CONCLUSIONS
  Owing to the cross-sectional design of this investigation it is not possible to conclude that smoking causes increased back pain through physical dysfunction. Nevertheless, the correlation should be analyzed in a longitudinal study because clarification of causality always represents potential for prevention.
authors.affiliation: Stiftung Orthopädische Universitätsklinik Heidelberg, Forschung, Schlierbacher Landstrasse 200a, Heidelberg, Germany. monique.zimmermann-stenzel@ok.uni-heidelberg.de
authors.forename: Monique
authors.initials: M
authors.lastname: Zimmermann-Stenzel
authors.forename: Julia
authors.initials: J
authors.lastname: Mannuss
authors.forename: Sven
authors.initials: S
authors.lastname: Schneider
authors.forename: Marcus
authors.initials: M
authors.lastname: Schiltenwolf