Adolescents suffering from back pain often are more likely to smoke cigarettes, drink alcohol, and report problems like anxiety and depression, according to a study.

Although often dismissed as trivial and fleeting, adolescent back pain is responsible for substantial health care use, school absence, and interference with day-to-day activities in some children. The findings showed that the rising frequency of pain increasing the proportion of participants reporting smoking, drinking, and missing school rose. 

For example, 14-15 year olds that experienced pain more than once a week were 2-3 times more likely to have drunk alcohol or smoked in the past month than those who rarely or never had pain. Similarly, students that experienced pain more than once a week were around twice as likely to have missed school in the previous term. 

The trend with anxiety and depression was less clear, although there was a marked difference between the children who reported no pain, and those who reported frequent pain, the researchers said. "Findings like this provide an argument that we should be including pain in the broader conversation about adolescent health," said lead author Steven Kamper from the University of Sydney in Australia. 

"Unfortunately our understanding of the causes and impacts of pain in this age group is quite limited, the area is badly in need of more research," Kamper added. For the study, detailed in the Journal of Public Health, the team used data collected from approximately 6,500 teenagers. 

Adolescent back pain may play a role in characterising poor overall health, and risk of chronic disease throughout life. The researchers believe this is of concern because the developing brain may be susceptible to negative influences of toxic substances, and use in early adolescence may increase the risk of substance abuse and mental health problems in later life.