From The Ergoweb® Learning Center

In Brief: How Research Has Linked Smoking to MSDs

Research: Smoking: A Risk Factor for Development of Low Back Pain in Adolescents. Feldman, Debbie Ehrmann PhD; Rossignol, Michel MD, MSc; Shrier, Ian MD, PhD; Abenhaim, Lucien MD, ScD.  Published in Spine. 24(23):2492, December 1, 1999.

Summary:  Over 500 students from grades 7 through 9 were assessed via questionnaire regarding lifestyle choices and habits; measurements were also taken of the students height, weight, trunk and leg flexibility. Results showed that the teens who smoked experienced low back pain more than the teens who didn’t smoke (odds ratio, 2.4).  Additionally, researchers found a dose-response relationship between amount smoked and development of low back pain.


Research: Smoking, Heavy Physical Work and Low Back Pain: a four-year prospective study. Eriksen, W; Natvig, B; and Bruusgaard, D. Published in Occupational Medicine, Vol 49, Issue 3 155-160. 1999.

Summary: Four-year prospective study intended to test the hypothesis that heavy physical work is a stronger predictor of low back pain in smokers than in non-smokers. Over 550 working respondents without low back pain during the entire year 1990 completed a questionnaire four years later. A job involving heavy lifting and standing in 1990 was found to be a strong predictor of low back pain in smokers four years later after researchers adjusted for other job characteristics, demographic factors, emotional symptoms, physical exercise and other musculoskeletal pain elsewhere. The same type job was not found to be associated with back pain four years later in the non-smokers in the study.


Research: Musculoskeletal Pain and Smoking in Norway. Brage, S; and Bjerkedal, T. Published in the Journal of Epidemiology and Community Health, Vol 50, 166-169.

Summary:  Over 6,600 individuals in a representative sample of households in Norway were questioned. Researchers found that current smoking was associated with musculoskeletal pain (odds ratio 1.69) after adjustment for gender, age, comorbidity, mental distress, lifestyle factors, and occupation-related factors. Additionally, researchers found that musculoskeletal pain was often present in more than one site in smokers.  Researchers concluded that smoking was significantly associated with musculoskeletal pain.


Research: Does Smoking Aggravate Musculoskeletal Pain? Eriksen, WB; Brage, S; Bruusgaard, D. Published in the Scandinavian Journal of Rheumatology. 1997;26(1):49-54.

Summary: Based on data from the Norwegian Health Survey 1985, researchers focused on all adult respondents who had reported musculoskeletal pain. Smokers were found to experience more intense pain than nonsmokers, although the association was seen only in respondents under the age of 67.


Research: Smoking and Musculoskeletal Disorders in the Metal Industry: a prospective study. Leino-Arjas, P. Pubished in Occupational and Environmental Medicine, Vol 55, 828-833.

Summary: Researcher Leino-Arjas set out to find the relationship between smoking and MSDs in an industrial setting, studying an initial sample of over 900 industrial and non-industrial employees through three measurements at five year intervals. Leino-Arjas concluded that smokers had higher rates of neck-shoulder symptoms, low back symptoms, upper limb symptoms and lower limb symptoms.  Smokers who quit smoking during the study had a higher increase in symptoms than respondents who had never smoked.

This article originally appeared in The Ergonomics Report™ on 2005-02-01.