Global burden and trends of smoking-related low back pain in women of childbearing age and projections to 2032: A secondary dataset analysis of Global Burden of Disease 2021

INTRODUCTION: This study used Global Burden of Disease (GBD) data to examine trends in smoking-related low-back pain (LBP) among women of childbearing age (WCBA) and project future trends. METHODS: This study is a secondary analysis of the GBD 2021 data. This study analyzes the temporal trends in the disability-adjusted life years (DALYs) caused by smoking-related LBP between 1990 and 2021 across 204 countries and territories. We evaluated the changing trends in the burden of smoking-related LBP in WCBA using the estimated annual percentage change (EAPC) and percentage change and Bayesian age-period-cohort modeling to forecast the burden to 2032. RESULTS: Globally, smoking-related low-back pain DALYs among women of childbearing age declined by 3% from 1990 to 2021, with the age-standardized rate falling from 84.58 to 56.54 per 100000 (EAPC= -1.39%). Regional disparities were pronounced: high-SDI regions accounted for 40.8% of the 2021 burden but saw a 22% decline, whereas low-SDI regions experienced a 54% increase. The largest national increases occurred in Qatar (733.3%) and the UAE (715.4%). Eastern Europe showed the greatest regional EAPC increase (1.85%), while Tropical Latin America declined most sharply (-2.68%). The age group of 45-49 years exhibited the highest 2021 DALY rate (140.2 per 100000), increasing 22% since 1990, contrasting with a 20% decline among those aged 30-34 years. Frontier analysis identified Greece, Chile, and Slovenia as having the greatest improvement potential. BAPC modeling projects a 17.24% decline in the global age-standardized DALY rate by 2032. CONCLUSIONS: The burden of smoking-related LBP in WCBA is shifting from high-income to low- and middle-income regions, with middle-SDI countries and older reproductive-age women facing escalating risks.