Impact of Tobacco Exposure on Low Back Pain-Related Disability-Adjusted Life Years in China: Trends From 1990-2021 and Projections for the Next 15 years Using ARIMA Modeling.

Background: Low back pain (LBP) is a leading cause of disability - adjusted life years (DALYs) globally. Tobacco exposure has been linked to LBP, but critical research gaps remain in quantifying its impact on LBP-related DALYs in China.

Objective: This study aims to analyze the disease burden of tobacco - related LBP among the Chinese population across all age groups from 1990 to 2021 using the latest Global Burden of Disease (GBD) 2021 data and project trends for the next 15 years.

Methods: We utilized data from the GBD 2021 study, applying joinpoint regression and age - period - cohort analysis to assess the disease burden of tobacco - related LBP among the Chinese population across all age groups. The autoregressive integrated moving average (ARIMA) model was employed to forecast future trends.

Results: From 1990 to 2021, the total DALYs attributed to tobacco - related LBP in China showed an increasing trend, while the age - standardized rate (ASR) significantly declined. Specifically, the ASR for females decreased more sharply than that for males. The joinpoint regression analysis revealed a significant overall downward trend in the disease burden. The age - period - cohort analysis indicated that age significantly impacts the ASR, which is high in middle - to - old age groups. The ARIMA model forecast predicts a continued decline in the ASR of DALYs over the next 15 years.

Conclusion: The findings highlight the positive impact of tobacco - control measures in reducing the disease burden of tobacco - related LBP in China. However, the persistent high burden among males and older age groups remains a challenge. Continued and targeted tobacco - control efforts are essential to further reduce the disease burden. The findings of this study provide critical evidence for formulating targeted tobacco control policies, supporting the enhancement of tobacco intervention measures for high-risk populations (eg, males and older adults) and the implementation of tobacco control strategies to reduce the LBP-related disease burden and improve population health outcomes.