Vitamin C is not the Missing Link Between Cigarette Smoking and Spinal Pain

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2018-01
• Main Authors: Dionne, Clermont E, Laurin, Danielle, Desrosiers, Thérèse, Abdous, Belkacem, Le Sage, Natalie, Frenette, Jérôme, Mondor, Myrto, Pelletier, Sylvie
• Format: Article
• Language: English
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0000000000002466

STUDY DESIGN.A nationwide cross-sectional study. OBJECTIVES.To measure the associations between cigarette smoking (defined as serum cotinine concentration > 15 ng/ml) and the 3-month prevalence of spinal pain (neck pain, low back pain, low back pain with pain below knee, and self-reported diagnosis of arthritis/rheumatism) and related limitations, and to verify whether these associations are mediated by serum concentrations of vitamin C. SUMMARY OF BACKGROUND DATA.Cigarette smoking has been consistently associated with back pain, but this association has never been explained. Because vitamin C has recently been reported to be associated with spinal pain and related functional limitations, and the metabolism of vitamin C differs between smokers and non-smokers, we hypothesized that the prevalence of spinal pain and related limitations might be greater among smokers because they are more susceptible to be in a state of hypovitaminosis C. METHODS.We conducted secondary analyses of National Health and Nutrition Examination Survey (NHANES) 2003–2004 data on 4,438 individuals aged ≥20 years. RESULTS.Serum concentrations of vitamin C and cotinine were strongly and inversely correlated (r = -0.35, p