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We aimed to estimate the global health and economic burden of LBP and RA attributable to smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The study was conducted in 192 countries and territories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Cases<\/jats:title><jats:p>Prevalent cases of LBP and RA were used, extracted from the Global Burden of Diseases, Injuries and Risk Factors Study 2019 data repositories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Smoking\u2010attributable health and economic burden was estimated with the population\u2010attributable fraction method. Smoking\u2010attributable prevalence of LBP and RA and health\u2010care costs were estimated for patients of all ages, whereas years lived with disability (YLDs) and productivity losses due to morbidity were estimated for patients aged 15\u201384\u2009years. Uncertainty intervals (UIs) of the results were obtained by repeating the analysis with the lower and upper bounds of all input variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Globally, smoking accounted for 84.5 million (UI\u2009=\u200956.7\u2013120.2 million) prevalent cases of LBP, 1.8 million (UI\u2009=\u20090.5\u20133.4 million) prevalent cases of RA and 11.3 million (UI\u2009=\u20096.2\u201318.5 million) YLDs, which represented 1.5% of all\u2010cause YLDs in the working\u2010age population aged 15\u201384\u2009years in 2019. Health\u2010care costs and productivity losses of smoking\u2010attributable LBP and RA cost the global economy purchasing\u2010power parity $326.0 billion (UI\u2009=\u2009$184.0\u2013521.4 billion), representing 0.2% of the global gross domestic product. Specifically, smoking accounted for $65.8 billion (UI\u2009=\u2009$38.0\u2013101.2 billion) in health\u2010care costs world\u2010wide, with more than half [$39.8 billion (UI\u2009=\u2009$23.1\u201361.3 billion), 60.6%] borne by the public sector. Smoking also contributed to $260.3 billion (UI\u2009=\u2009$146.0\u2013420.3 billion) in productivity losses globally. Approximately 60.0% of the global YLDs were observed in middle\u2010income countries, whereas 84.4% of health\u2010care costs and 72.7% of productivity losses were borne by high\u2010income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Globally, in 2019, smoking accounted for more than 11.0 million years lived with disability and purchasing\u2010power parity $326.0 billion in economic losses due to low back pain and rheumatoid arthritis. Middle\u2010income countries suffered more morbidity, whereas high\u2010income countries experienced larger economic losses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16404","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T01:43:00Z","timestamp":1702863780000},"page":"677-685","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Health and economic burden of low back pain and rheumatoid arthritis attributable to smoking in 192 countries and territories in 2019"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5419-8505","authenticated-orcid":false,"given":"Ningjing","family":"Chen","sequence":"first","affiliation":[{"name":"School of Nursing Putian University  Putian China"},{"name":"School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7365-9146","authenticated-orcid":false,"given":"Daniel Yee Tak","family":"Fong","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3000-4577","authenticated-orcid":false,"given":"Janet Yuen Ha","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"School of Nursing and Health Studies Hong Kong Metropolitan University  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41571"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.44198"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2015.08.002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.869239"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.50674"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230902"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-022-00462-1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.51.1.29"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri803"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2016-053305"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30752-2"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0734"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5742-6"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16885"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003476"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2019.34.e80"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000396"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ergon.2020.102933"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01258-7"},{"key":"e_1_2_9_22_1","unstructured":"Institute for Health Metrics and Evaluation.Terms defined. 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