Your Spine on Nicotine
E-cigarettes, smoking tobacco and the health of your spine
If you are a smoker and/or e-cigarette vaper with low back or neck pain, and have consulted a spine surgeon or related specialist, chances are you’ve been advised to quit. Maybe you are tired of hearing (or reading) the message—quit today. Let’s face it, for decades Americans have been admonished to quit smoking and tobacco product use.
E-cigarettes—A Safer Smoke?
Electronic cigarettes or e-cigarettes are also known as electronic nicotine delivery systems or ENDS. These battery-powered devices are designed to resemble traditional tobacco products (eg, cigarettes, pipes), although some of these products look like a pen or memory stick. An e-cigarette delivers nicotine in a heated flavored vapor.
- Some people use e-cigarettes without nicotine believing them to be safe, and a means to augment tobacco cessation. However, a study performed by the Center for Environmental Health showed the nicotine-free devices delivered acetaldehyde and formaldehyde, both cancer-causing chemicals.
- E-cigarettes are not approved by the U.S. Food and Drug Administration as part of a tobacco smoking cessation program.
Concern about potential health risks has been raised by many public health experts. Besides what is already known about the damaging effects of nicotine, not a lot is known about the flavorings and chemicals in and potential reactions during e-cigarette use. Therefore, the question as to whether e-cigarettes are safer than smoking tobacco remains unanswered.
Nicotine and Osteoporosis
Smoking tobacco increases the risk for osteoporosis; a serious disease that causes loss of bone mineral density or bone’s mass—the strength of bones in the body. It starts with the effects of nicotine, a vasoconstrictor that reduces blood flow to tissues throughout the body. Proper circulation of blood is essential to deliver oxygen and nutrients bone cells need to reproduce and maintain density. Nicotine also slows the production of osteoblasts—cells that form new bone. Furthermore, smoking interferes with the body’s ability to absorb calcium and more quickly breaks down estrogen—both of which are vital to healthy bones.
- Fact: Osteoporosis is a contributing risk factor to painful vertebral compression fractures.
Tobacco Use and Spine Surgery
If you smoke, your spine surgeon may recommend you quit four to six weeks before your surgery, and remain nicotine free for four weeks thereafter. This can reduce your risk of wound complications by 50%.1
Nicotine and General Anesthesia
The effects of smoking tobacco can begin with administration of general anesthesia, which is commonly used for spine surgery. First, nicotine increases heart rate, meaning your heart is pumping more and working harder. Blood pressure may increase and because nicotine is a vasoconstrictor, blood vessels narrow. People who smoke produce more mucus that may affect the airway and complicate breathing while under anesthesia. Additional medication (eg, albuterol, a bronchodilator) may be needed to increase oxygen intake.
Nicotine and Wound Healing
People who smoke may experience complications related to wound healing, including an increased risk for infection. Furthermore, it can take longer for surgical wounds to heal. This can happen because smokers have more carbon monoxide in their bodies that steals the oxygen needed to expedite healing of tissues.
Nicotine and Spinal Fusion
The goal of spinal fusion is two or more bones healing/growing together. However, tobacco use increases the risk for an incomplete fusion, failed fusion, or nonunion.