Cervical disc degeneration and smoking

I had an “interesting” conversation with a patient yesterday. We were reviewing the gentleman’s cervical X-rays and the rather surprising amount of cervical disc degeneration it showed, out of line with his age and the amount of trauma he could recall. When reviewing all risk factors for cervical degenerative disc disease, I pointed out that smoking is a big risk factors, up to 4 times the incidence versus non-smokers. Somehow that piece of information did not sit well with the gent in question, who smokes well over a pack a day and seems quite in denial about the ill effects of his habit. However, science talks louder than our denial and I forwarded him this piece of research, to let him argue with the authors if he choses. And I thought it might be a good talking point for anyone else reading this blog to have on hand