title: Lateral Epicondylitis and Tobacco Use: A Case-Control Study.
abstract: BACKGROUND
  Although lateral epicondylitis (LE) is a very common tendinopathy, we understand little about the etiology of the disease. Tobacco use has been associated with other tendinopathies, and the purpose of this study is to determine if there is an association between the incidence of lateral epicondylitis and tobacco use.
  
  
  METHODS
  We performed a retrospective cohort study of adult patients diagnosed with lateral epicondylitis. Patients from a single orthopaedic surgeon's practice with LE were matched to control patients with other common upper extremity conditions based on age, gender, and occupation. A total of 65 case patients and 217 control patients were included in the study. The incidence of smoking in patients with lateral epicondylitis was compared to the incidence of smoking in the control group.
  
  
  RESULTS
  Of the LE patients, 30/65 (46.2%) were non-smokers, 23/65 (35.4%) were former smokers, and 12/65 (18.5%) were current smokers. Of the control patients, 121/217 (55.8%) were non-smokers, 45/217 (20.7%) were former smokers, and 51/217 (23.5%) were current smokers. The odds of LE patients being former or current smokers compared to control patients were 1.45 times higher, but this was not statistically significant. Among people who did not smoke at the time of presentation, the odds of being a former smoker were 2.28 times higher in LE patients than in controls, which was statistically significant.
  
  
  CONCLUSIONS
  The odds of being a former smoker were significantly higher in patients with lateral epicondylitis compared to patients with other upper extremity conditions. Although it did not reach statistical significance, the odds of being former or current smokers were also higher in the LE group. These results suggest a relationship between smoking history and incidence of lateral epicondylitis, though more research is needed to determine the exact nature of the relationship.
  
  
  METHODS
  Prognostic, Level III.
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota , Minneapolis, MN ; Department of Orthopaedics, Regions Hospital , St. Paul, MN.
authors.forename: Avery E
authors.initials: AE
authors.lastname: Michienzi
authors.affiliation: Health Partners Institute for Research and Education , Bloomington, MN.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Anderson
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota , Minneapolis, MN ; Department of Orthopaedics, Regions Hospital , St. Paul, MN.
authors.forename: Sandy
authors.initials: S
authors.lastname: Vang
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota , Minneapolis, MN ; Department of Orthopaedics, Regions Hospital , St. Paul, MN.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Ward
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects*; D013716:Tennis Elbow / Q000175:diagnosis* / Q000453:epidemiology*; D064424:Tobacco Use / Q000009:adverse effects*