The Oxford Journal on Rheumatology hypothesizes that the reason for a higher of incidence of back pain amongst smokers is that smoking leads to malnutrition of discs, which in turn become more brittle and vulnerable to stress. Nicotine constricts blood vessels (known as nicotine-induced vasoconstriction), and can potentially cause changes to interior arterial walls and blood flow. More efficient blood flow may be the reason why the anti-smoking crowd has less back pain.

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