Kshitij ChaudharyOf all the risk factors for back pain, smoking is one of the most underestimated — and one of the few patients have real, direct control over.
How smoking affects your discs
The discs between your vertebrae don't have their own direct blood supply — they depend on small vessels at their edges to deliver oxygen and nutrients. Nicotine and carbon monoxide in cigarette smoke constrict these vessels, reducing blood flow and starving the discs of what they need to stay healthy. Over time, this speeds up disc degeneration and dehydration (desiccation), and raises the risk of disc herniation and spinal stenosis.
How smoking affects your bones
Smoking lowers bone mineral density, which weakens the vertebrae and increases the risk of fractures and osteoporosis in the spine — a risk that becomes more significant with age.
How smoking affects your recovery
Whether you're recovering from a simple back strain, a disc problem, or spine surgery, smoking measurably slows healing. Studies in spine surgery consistently show smokers have higher rates of delayed bone fusion and wound complications than non-smokers. This is one of the main reasons surgeons ask patients to stop smoking well before any planned spine procedure.
The good news
Unlike many risk factors for back pain — age, genetics, the shape of your spine — smoking is one you can actually change. Quitting, even at this stage, measurably improves bone health and surgical outcomes over time. It's never too late to stop.
The takeaway
If you smoke and have back pain, quitting is one of the most effective things you can do for your spine — alongside staying active and following the advice in The Back Pain Guide. Speak to your doctor if you'd like support quitting.