Risk factors for low back pain with special reference to current smoking

We appreciate Prof Kawada's thoughtful letter regarding our recent review. Prof Kawada focuses on smoking as a potential risk factor for low back pain. We would add that smoking clearly increases the risk of other chronic diseases [1–3], and accordingly, even when there are doubts about whether it increases the risk of low back pain, we should still discourage smoking because it harms other aspects of health.

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