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Risk of bias assessment Only one study was classified as having low risk of bias 27 , while nearly all studies 23-26,28-33 (10 out of 11) were judged to have a high risk of bias or poor quality, primarily due to the domain of outcome measurement (Supplementary file Tables 6 and 7)
Licence: CC BY-NC-SA 3.0 IGO WHO study group on tobacco product regulation
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Other harmful effects of tobacco on the spine are the degeneration of the bone matrix which makes osteoporosis more likely, and greater structural damage to the vertebrae, poor post-surgical healing, and worse and weaker healing overall
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