People who smoke may also experience more low back pain than nonsmokers. Smoking is associated with an increase in the incidence of rheumatoid arthritis. Nicotine, the most powerful substance in tobacco, ultimately causes a decrease in blood flow to all tissues in the human body. This is most pronounced in the hands and feet. Decreased blood flow in the hands and feet due to smoking can lead to death of tissue, requiring amputation of a hand or foot.
Smokers also have a higher incidence of hand contraction and nerve problems.
Patients who smoke have a higher complication rate from surgery than nonsmokers. Outcomes following surgical bone procedures in smokers are not as satisfactory as for nonsmokers. Cigarette smoking represents a risk factor, which can be avoided by the individual and the effects are potentially reversible. The potential for savings in health care expenditure is enormous. J Spinal Disord.