Revolutionizing Spine Care…Changing Lives

How Smoking Causes Serious Back Problems

For the past 40-years, those poor souls who are huddled together outside, in all kinds of weather, get a little positive nudge to put down their cigarettes, for at least one day. Thursday, November 19th marks the American Cancer Society’s Great American Smokeout and this is a day when smokers are encouraged to quit for the day and make a plan to quit for good.

According to the American Cancer Society (ACS), smoking rates have dropped dramatically in the past several decades, from about 42% of adults in 1965 to about 18% in 2012, the latest year for which numbers are available. However, about 42 million adults currently smoke cigarettes, and tobacco remains a major killer, responsible for nearly one in five deaths in the United States, and at least 30% of all cancer deaths.

Many of the health risks of smoking are well-known. Lung cancer, pulmonary diseases, mouth and esophagus cancer are all caused by smoking. However, what is less known is that smoking can also cause spinal degeneration and severe back pain.  Dr. Rajesh Arakal, a spine surgeon at Texas Back Institute explains this below.

Quit Like a Champion!


Joy Donovan Brandon of the ACS noted, “The first ‘smokeout’ was in California and research confirmed that as a result of this initial effort more than a million people stopped smoking. The next year, the American Cancer Society took the program national.”

What is it about the Great American Smokeout that helps smokers put down their packs forever?

“November 19th is just another day on the calendar” Joy notes. “Some people quit on January 1st or their birthday. We give them one more day to think about quitting, offering support and raising awareness of the health risks. This year our theme is “Quit Like a Champion. If you quit smoking, you’re a champion for your co-workers, your family and yourself.”

Those who quit might also realize another benefit – a healthier spine.

How Smoking Can Lead to Serious Back Problems


“By breaking down the active ingredients in smoke, such as nicotine, we can determine how they might relate to spinal disease,” Dr. Arakal said. “Nicotine can cause narrowing and constriction of blood vessels in the body.

“Unfortunately, some of the very small blood vessels are very important for nutrition to the discs in the spine. When this happens, the discs which might have a slower rate of deterioration can begin to have an accelerated rate. This can be dose (of the nicotine) dependent,” he said. “People who have been smoking for a long period of time, or have a multiple-packs-a-day habit can suffer these ramifications.”

“As smoking has changed over the years, to something like ‘vapor,’ which sounds more innocuous, the active ingredients such as nicotine are still very much present. Those harmful effects will not be lessened by inhaling vapor rather than traditional cigarette smoke.”

“There are other harmful chemicals found in this smoke besides nicotine,” he noted. “I don’t think researchers have a good handle on all of the damaging elements found in smoke. There is more work to be done to quantify the effects of these harmful chemicals.”

Are Older Smokers at Greater Risk?

“We understand that there is a genetic disposition towards back pain,” Dr. Arakal said. “In general, we think of older patients of having a higher probability of spinal disease. This is because they have more years of wear and tear and micro-traumas have accumulated in the spine.

“Certainly, older people are going to have more likelihood of multiple causes for spine problems, whether it be disc problems or a combination of many, smaller traumas which weaken the spine. Arthritis is also more prevalent among older patients and this can lead to spinal stenosis and nerve pain.”

How Long Does it Take to Realize the Benefit of Smoking Cessation?

If someone uses the Great American Smokeout and support from other non-smokers to stop smoking, is there any immediate benefit to that individual’s spinal health?

“I think there are positive effects of smoking cessation anytime someone breaks this habit, at whatever age,” he said. “For example, from a pulmonary standpoint, we have seen incremental improvements within days of the patient stopping smoking. However, if someone has serious spinal disease and they stop smoking, I don’t believe this condition ‘auto-corrects.’ There is a positive effect when someone stops smoking. It slows the rate of degeneration of the spine.”

“For those we feel require spine surgery, we recommend they stop smoking for several reasons, “ he said. “Successful surgery requires good biology. So, if someone stopped smoking on the day of the surgery, their ability to recover will be better than someone who didn’t stop. The non-smoker will heal better from the surgery and have a much better outcome.

Want to Get Involved in the Great American Smokeout?


“The American Cancer Society has a toll-free number help-line,” Joy Brandon notes. “That number is 800-227.2345. We have trained staff answering those lines and they will have tips and tools on ways you can quit smoking. “We hope everyone quits like a champion this year!”



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