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Health & Exercise Forum

Good Reasons to Quit Smoking: Part 1 of 2

Nov 10, 2014

Dr. Mackarey's Health & Exercise ForumNeed Another Reason to Quit Smoking? Studies Show That Smokers Are More Likely to Suffer From Lower Back Pain and Failed Back Surgery!


Part I of II


The American Cancer Society marks the third Thursday of November each year as The Great American Smokeout! The Smokeout, in combination with many other campaigns to raise the level of awareness about the dangers of smoking, is working as smoking has declined from 20.9% in 2005 to 18.1% in 2012. According to the Centers for Disease Control, 42.1 million adults in the United States smoke cigarettes.

Smoking is the leading cause of preventable death in the US and more than 16 million Americans suffer from a disease caused by smoking. It is well documented that smoking causes cancer, heart attacks, atherosclerosis (hardening of the arteries), lung disease (bronchitis, emphysema, coughing, shortness of breath), and damage to the skin which leads to wrinkles and premature aging. Smoking also causes discoloration of teeth and fingers and causes bad breath. In recent years, several studies have discovered the strong relationship between smoking and back pain and failed back surgery. The fact that more than 80% of the population will suffer from back pain at some point in their lives makes these findings vitally important!


Smoking – Effect on the Body

Lungs – With every breath, the lungs take in oxygen and expel carbon dioxide. It is the most basic of all gases necessary to sustain life as it provides cells and tissues of the body require oxygen to be healthy. Smoking interferes with lung function, as damaged lung tissue is unable to adequately exchange oxygen and carbon dioxide.

Heart and Blood Vessels - Smoking causes plaque deposits to build up inside the blood vessels of the body, including the heart, which leads to narrowing of the vessels and compromised blood flow.

Digestion – Smoking causes inflammation and irritation of the lining of the digestive tract, it interferes with the absorption of nutrients.

Muscle and Bone – Due to the decreases in oxygen from the damaged lungs, compromised blood flow from the narrow blood vessels, lack of nutrients from the irritated digestive tract, other vital systems of the body are unable to remain healthy. The musculoskeletal system (muscle-bone) is one of the most vulnerable parts of the body as it requires a significant amount of blood, oxygen and nutrients to maintain strong muscles and bones to move and support the body.

Smoking and Back Pain - Smoking contributes to atherosclerosis, which limits blood flow, which limits the delivery of oxygen and nutrients to the muscles, discs and joints of the spine. The muscles of the spine work hard to maintain an erect posture during sitting, standing, bending, let along lifting crates at work, running and playing sports. These hard working muscles require adequate oxygen to work at maximal capacity and prevent fatigue in order to protect the spine. Additionally, oxygen deprived muscles are more likely to suffer from painful cramps and spasms. Studies also show that younger people who smoke suffer from earlier onset of back pain.

Pain – Smokers have a higher rating of pain, including lower back pain, than nonsmokers. Researchers believe this may be due to the fact that nicotine interferes with the production of the natural pain control chemicals in the body. With less of these chemicals, pain is more prevalent. Additionally, as mentioned above, the muscles of the back lack necessary oxygen and nutrients in smokers which leads to painful spasms.

Bone Quality – smoking has a negative impact on bone quality as the cells that build bone are inhibited by nicotine. Bones that are less dense (osteoporosis) are more likely to be weak, suffer from painful compression fractures, and less likely to rebuild bone with aging and heal from trauma or surgery.

Surgical Recovery – smokers are significantly less likely to heal from surgery due to the above description of poor bone quality from nicotine. Some studies show up to 47% failure rates from back fusion as compared to 8% in nonsmokers. Furthermore, due to the fact that smoking compromises the immune system, smokers are more likely to suffer from post operative infections following a spinal fusion.


Smoking and Failed Back Surgery

 The body was genetically engineered to heal. Given the proper opportunity for adequate rest, nutrition, oxygen, blood flow and protection from additional injury, the body, including the muscles, discs and joints of the spine, will typically heal. In view of this, the importance for smoking cessation cannot be overstated. Many back surgeons require a blood test for nicotine before they will perform surgery to limit the likelihood of failure. Moreover, as damaging as smoking is, the body is amazingly resilient. It is NEVER too late to quit smoking and allow your body to use oxygen and nutrients from clean air to restore, recover and heal.

** Medical Contributor: Leslie Lyness, DO, Associate Neurosurgeon at Geisinger Community Medical Center, Scranton, PA. Dr. Lyness completed her BS in Biology at University of North Carolina at Chapel Hill, Doctor of Osteopathic Medicine at Philadelphia College of Osteopathic Medicine and was a member of the 1996 USA National and Olympic Field Hockey Team.


Visit your doctor regularly and listen to your body.

Keep moving, eat healthy foods, and exercise regularly


NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in The Times-Tribune. Next Week Read Part II of Smoking and Back Pain.


This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:


Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate clinical professor of medicine at The Commonwealth Medical College in Scranton, PA.