My girlfriend is trying to quit smoking. Not because she is worried about wrinkles or because she is afraid of emphysema. My girlfriend is quitting because she has neck pain and her orthopaedic doctor has told her that a nicotine addiction could explain some of her physical symptoms. Here is an eye opening statistic: People who smoke are 2.7 times more likely to develop low back pain than people who don’t smoke. Smoking effects the muscles, bones and ligaments in the body by decrease their available oxygen. Research has shown that this reduction in blood flow occurs because nicotine causes a thickening of the blood vessel walls. So, if you smoke, you have weaker bones, weaker muscles and weaker ligaments – the perfect recipe for low back pain, neck pain, fractures and poor recovery after surgery. What cannot be said about smoking is that it will automatically cause degenerative changes in the neck. A study published this year by Spine looked at 200 asymptomatic men and woman (half smokers and half non-smokers). The researchers found no differences in cervical joint health between the two groups. Will I be telling my girlfriend about that study? Probably not. That particular study looked at people with no pain symptoms. We can think of them as “lucky smokers.” My girlfriend has not been so lucky. The combination of a grueling desk job and a long history of smoking, has set her up for severe neck pain. I am holding my breath that she will have enough willpower to quit; not only because I think it will give her neck a fighting chance at recovery, but also because second hand smoke weakens MY muscles too.