Long-Term and Heavy Smoking as a Risk Factor for Lumbar Spinal Stenosis: Evidence from a Large-Scale, Nationwide...

Area of Science:

• Epidemiology
• Public Health
• Gerontology

Background:

• Lumbar spinal stenosis (LSS) is a significant cause of disability in the elderly population.
• The specific impact of cigarette smoking on LSS development requires further clarification.
• Understanding smoking's role is vital for targeted prevention strategies.

Purpose of the Study:

• To investigate the association between cigarette smoking and the incidence of lumbar spinal stenosis (LSS).
• To examine dose-response relationships and variations in risk across age and sex subgroups.
• To provide evidence supporting smoking cessation interventions for spinal health.

Main Methods:

• A nationwide, population-based cohort study utilizing the Korean National Health Insurance Service database.
• Inclusion of over 2 million adults aged 40+ screened in 2009, followed until 2020.
• Analysis using Cox proportional hazards models, adjusting for multiple confounding factors.

Main Results:

• A statistically significant increased risk of LSS was observed in both former and current smokers compared to never smokers.
• A clear dose-response relationship was evident, with the highest risk associated with heavy smoking (≥40 pack-years).
• Stronger associations between smoking and LSS incidence were found in individuals aged 65 and older, and in women.

Conclusions:

• Cigarette smoking is an independent risk factor for developing lumbar spinal stenosis (LSS).
• The risk of LSS increases proportionally with the cumulative lifetime exposure to smoking.
• Public health initiatives promoting smoking cessation are essential for mitigating the burden of LSS and spinal degeneration, particularly in vulnerable populations.