“…It is surprising that the multivariate analyses did not identify a significant association between smoking and disability following any of the back disorders or carpal tunnel syndrome, given the substantial literature associating smoking with the incidence (though not necessarily the development of disability) of these conditions [Frymoyer et al, 1980;Svensson et al, 1983;Kelsey et al, 1984;Owen and Damron, 1984;Biering-Sørensen and Thomsen, 1986;Saraste and Hultman, 1987;Battié et al, 1989;Deyo and Bass, 1989;Vessey et al, 1990;Heliövarra et al, 1991;Tsai et al, 1992;Boshuizen et al, 1993;O'Connor and Marlowe, 1993;Reynolds et al, 1994;Finkelstein, 1995;Nathan et al, 1996;Tanaka et al, 1997]. Perhaps there are many more causal pathways and mediating factors for back disorders that dilute the effect of smoking.…”