title: Bidirectional relationships between cigarette use and spinal pain in adolescents accounting for psychosocial functioning.
abstract: OBJECTIVE
  The objective of this study was to determine the presence of possible bidirectional causal pathways between cigarette use and spinal pain in adolescents controlling for psychosocial functioning, using a prospective longitudinal research design.
  
  
  METHODS
  The data for this study was collected from a cohort of Australian adolescents at 14 (n = 1596) and 17 (n = 1291) years of age.
  
  
  METHODS
  Multivariable logistic regression was used to assess i) if cigarette use at 14 predicted low back pain (LBP), mid back pain (MBP) or neck shoulder pain (NSP) at 17 in those adolescents without each condition at 14, and ii) if back pain only (BP), neck shoulder pain only (NSP) or comorbid BP and NSP at 14 predicted cigarette use at 17 in those adolescents who did not smoke at 14.
  
  
  RESULTS
  After controlling for psychosocial factors, cigarette use at 14 predicted MBP at 17 (OR = 3.05, p = 0.049, 95% CI [1.01-9.24]). BP only at 14 was a significant risk factor for smoking at 17 (OR = 1.84, p = 0.006, 95% CI [1.19-2.84]) after controlling for psychosocial factors.
  
  
  CONCLUSIONS
  The findings indicate that there are bi-directional relationships between cigarette use and spinal pain and that these relationships vary with pain location.
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia; Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
authors.forename: Davinder K
authors.initials: DK
authors.lastname: Gill
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Davis
authors.forename: Anne J
authors.initials: AJ
authors.lastname: Smith
authors.forename: Leon M
authors.initials: LM
authors.lastname: Straker
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001416:Back Pain / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003863:Depression / Q000523:psychology; D005192:Family Health; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D019547:Neck Pain / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D020377:Self Efficacy; D012737:Sex Factors; D020069:Shoulder Pain / Q000453:epidemiology* / Q000523:psychology; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D012923:Social Class