TY - JOUR
T1 - Association of Cigarette Smoking with Risk of Chronic Musculoskeletal Pain
T2 - A Meta-Analysis
AU - Dai, Yan
AU - Huang, Jiachen
AU - Hu, Qinghui
AU - Huang, Lili
AU - Wu, Jie
AU - Hu, Jun
N1 - Funding Information: Address Correspondence: Jun Hu, MD, PhD Department of Orthopedics, the First Affiliated Hospital of Nanjing Medical University Guang Zhou Road 300 Nanjing, 210029, China E-mail: [email protected] Disclaimer: This work was supported by grants from the National Natural Science Foundation of China (No. 81373397, 81672218 and 81603092). Funding Information: This work was supported by grants from the National Natural Science Foundation of China (No. 81373397, 81672218 and 81603092). We would like to thank the authors of the studies included in this meta-analysis for their responsiveness to questions about their work. Publisher Copyright: © 2021, American Society of Interventional Pain Physicians. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Chronic musculoskeletal pain (CMP) management is a major global public health goal owing to increased social and economic burdens. However, the risk of CMP in smokers compared with nonsmokers remains uncertain. Objectives: This study aims to determine the magnitude and importance of the relationship between cigarette smoking and risk of CMP. Study Design: A meta-analysis of the CMP risk of cigarette smokers. Methods: We systematically searched PubMed, Embase, and Cochrane library databases from inception to August 2020. Data extraction and quality assessment were performed by 2 independent reviewers using a standardized extraction checklist. Data were pooled using a random-effects model. Results: In this meta-analysis of 32 studies involving 296,109 participants, current smoking was associated with increased CMP risk (OR: 1.23, 95% CI: 1.09-1.40), whereas ever and past smoking did not show such an association (OR: 1.14, 95% CI: 0.95-1.37; OR: 1.06, 95% CI: 0.83-1.35, respectively). Stratified analyses showed that there was a marked significance in almost all strata of current smokers compared with non-smokers, except for mean age (≥ 50 years), location of pain (neck pain, sacral pain, and knee pain), smoking frequency (occasionally), study design (cross-sectional), mean follow-up (< 10 years), and adjustment for confounding factors (≥ 6). Interestingly, there was statistically negative association between cigarette smoking and knee pain risk in current smokers, ever smokers, and past smokers. Limitations: The major limitation of this meta-analysis relates to the heterogeneities across included studies. Conclusions: Cigarette smoking was associated with increased risk of CMP. In view of the high prevalence of smoking in many countries and the increasing number of CMP patients worldwide, reducing tobacco use should be an important public health strategy to prevent and control the global epidemic of CMP. Future research should attempt to establish whether this association is causal and clarify its mechanisms.
AB - Background: Chronic musculoskeletal pain (CMP) management is a major global public health goal owing to increased social and economic burdens. However, the risk of CMP in smokers compared with nonsmokers remains uncertain. Objectives: This study aims to determine the magnitude and importance of the relationship between cigarette smoking and risk of CMP. Study Design: A meta-analysis of the CMP risk of cigarette smokers. Methods: We systematically searched PubMed, Embase, and Cochrane library databases from inception to August 2020. Data extraction and quality assessment were performed by 2 independent reviewers using a standardized extraction checklist. Data were pooled using a random-effects model. Results: In this meta-analysis of 32 studies involving 296,109 participants, current smoking was associated with increased CMP risk (OR: 1.23, 95% CI: 1.09-1.40), whereas ever and past smoking did not show such an association (OR: 1.14, 95% CI: 0.95-1.37; OR: 1.06, 95% CI: 0.83-1.35, respectively). Stratified analyses showed that there was a marked significance in almost all strata of current smokers compared with non-smokers, except for mean age (≥ 50 years), location of pain (neck pain, sacral pain, and knee pain), smoking frequency (occasionally), study design (cross-sectional), mean follow-up (< 10 years), and adjustment for confounding factors (≥ 6). Interestingly, there was statistically negative association between cigarette smoking and knee pain risk in current smokers, ever smokers, and past smokers. Limitations: The major limitation of this meta-analysis relates to the heterogeneities across included studies. Conclusions: Cigarette smoking was associated with increased risk of CMP. In view of the high prevalence of smoking in many countries and the increasing number of CMP patients worldwide, reducing tobacco use should be an important public health strategy to prevent and control the global epidemic of CMP. Future research should attempt to establish whether this association is causal and clarify its mechanisms.
KW - Cigarette
KW - chronic musculoskeletal pain
KW - meta-analysis
KW - nicotine
KW - public health
KW - risk
KW - smoking
KW - tobacco
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M3 - Article
C2 - 34793634
SN - 1533-3159
VL - 24
SP - 495
EP - 506
JO - Pain physician
JF - Pain physician
IS - 8
ER -