The Link Between Cigarette Smoking and Degenerative Disc Disease

Fingers holding a burning cigarette

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Cigarette smoking is a leading risk factor for degenerative disc disease (DDD). The term “degenerative disc disease” has been criticized by some because all discs do degenerate naturally over time. It's a normal part of the aging process. However, in some younger adults, the discs degenerate more quickly. This causes the discs to lose fluid, become less pliable, and less protective and supportive of the vertebrae. The result is chronic and debilitating pain.

The Arthritis Foundation notes that DDD is not actually a disease, but that it is "a condition in which pain is caused by a disc that wears down."

Smoking Is a Leading Risk Factor for DDD

Although genetic predisposition is the number one risk factor for DDD, a growing number of studies indicate that smoking is another leading risk factor for DDD, both in the lumbar discs (lower back) and cervical discs (neck).

Research suggests that smokers have a greater risk of developing DDD, and that smoking can exacerbate a pre-existing disc degeneration.

Smoke and Disc Degeneration

Nicotine deprives disc cells of vital nutrients. In addition to nicotine, when you smoke, you introduce carbon monoxide into the bloodstream and from there into your body tissues. These poisons inhibit the discs’ ability to absorb the nutrients they need from the blood. The result can be prematurely dehydrated, less pliable discs—degenerated discs.

As the discs become more and more malnourished, there is a greater risk of a ruptured disc. This occurs when the disc contents break through the outer layer of the disc, often impinging on nerves and causing great pain, numbness, and in some cases nerve damage in the legs or arms. These same poisons also interfere with the absorption of calcium, leading to a compromised vertebral structure.

More Smoking Risks Related to Degenerative Disc Disease

Other risks that relate to smoking and DDD include:

  • Coughing, which is more prevalent among smokers, can also add to the risk of DDD. Coughing causes increased pressure between discs, which puts added strain on the spine and discs, creating a greater risk of disc bulges and ruptures, especially in a spine already weakened because of smoking-related toxins.
  • Inactivity, which is frequently associated with the smoker’s lifestyle, can result in a higher frequency of back pain in general. Unfortunately, pain associated with DDD can make an active lifestyle that much more difficult to enjoy.


Treatment for DDD and disc ruptures ranges from doing nothing to major surgery, including spinal fusion. This surgical procedure involves removing disc material and fusing the vertebrae together with bone grafts and sometimes metal plates, rods, and screws. Management and treatment options often involve the use of nonsteroidal anti-inflamatory drugs (NSAIDS) and physical therapy.

It is important to be evaluated by your doctor in order to determine the treatment approach that is right for you.

Anyone who is still smoking by the time this surgery is required is strongly advised to quit smoking prior to surgery. Many surgeons will not perform the surgery until you have been smoke-free for several months. Smoking impedes new bone growth, which is instrumental in the success of spinal fusion. Researchers have determined that nicotine is a bone toxin and as a result, the failure rate for many types of fusions is higher for smokers.

More research is being done to study the relationship between smoking and DDD, but there is evidence to suggest that quitting smoking now may reduce the risk of developing or exacerbating DDD.

Don't Take the Gamble

To those who might be contemplating quitting and wondering if you have another 10, 20, or 30 years to smoke before you do any real or lasting damage, please think again. Think about what you’re putting on the line. For every warning actually listed on a pack of cigarettes, there are many more illnesses, diseases, and complications that smoking can cause.

Try to quit now, and at least know that from this day forward you're doing all you can to protect your health and well-being.

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Article Sources
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  1. Association of Academic Physiatrists. Smoking cigarettes can be a chronic pain in your neck: Smoking linked to cervical degenerative disc disease. Published February 17, 2016.

  2. Arthritis Foundation. Degenerative disc disease.

  3. Elmasry S, Asfour S, de Rivero Vaccari JP, Travascio F. Effects of tobacco smoking on the degeneration of the intervertebral disc: a finite element studyPLoS One. 2015;10(8):e0136137. doi:10.1371/journal.pone.0136137

  4. Jackson KL 2nd, Devine JG. The effects of smoking and smoking cessation on spine surgery: a systematic review of the literatureGlobal Spine J. 2016;6(7):695–701. doi:10.1055/s-0036-1571285

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