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1- Substance Abuse and Dependence Researcher Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
3- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
4- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
3- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
4- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract: (18 Views)
Purpose: Traditional opium smoking may require prolonged, repetitive, and non-neutral positioning of the head, neck, and trunk. Although cervical impairments have been reported among chronic opium smokers, the effects of specific smoking instruments remain unclear.
Methods: This secondary cross-sectional analysis of the first author’s doctoral thesis included 123 adults with opioid dependence and a history of opium smoking. Lifetime and daily exposure were recorded separately for vafour (traditional opium pipe), gholgholi, and sikh-o-sang. A study-derived Integrated Cervical Neuromusculoskeletal Dysfunction Index (ICND) combined standardized measures of pain, neck disability, neck symptoms, thoracic kyphosis, forward head posture, cervical range of motion, and neck-muscle force. Spearman correlations and multivariable linear regressions with HC3 robust standard errors were performed, adjusting for age, sex, body mass index, cigarette consumption, and dependence severity.
Results: The ICND showed acceptable internal consistency (Cronbach’s alpha=0.717). Total smoking duration (rho=0.564), daily vafour exposure (rho=0.560), and cumulative vafour exposure (rho=0.481) had the strongest correlations with ICND (all p<0.001). In the cumulative-exposure model, vafour duration independently predicted higher ICND scores (standardized beta=0.295, 95% CI 0.068-0.523; p=0.011); the model explained 37.9% of ICND variance. In the daily-exposure model, daily vafour duration was the strongest independent predictor (standardized beta=0.394, 95% CI 0.238-0.550; p<0.001), with 44.3% of variance explained. Daily vafour exposure was also associated with greater pain, a smaller craniovertebral angle, greater kyphosis, restricted cervical range of motion, and reduced neck-muscle force.
Conclusions: Longer daily vafour use was the most consistent instrument-specific correlate of worse cervical dysfunction. Opium smoking posture and exposure duration should be considered in musculoskeletal assessment of chronic opium smokers. Prospective studies with direct posture measurement are needed to clarify temporality and causation.
Methods: This secondary cross-sectional analysis of the first author’s doctoral thesis included 123 adults with opioid dependence and a history of opium smoking. Lifetime and daily exposure were recorded separately for vafour (traditional opium pipe), gholgholi, and sikh-o-sang. A study-derived Integrated Cervical Neuromusculoskeletal Dysfunction Index (ICND) combined standardized measures of pain, neck disability, neck symptoms, thoracic kyphosis, forward head posture, cervical range of motion, and neck-muscle force. Spearman correlations and multivariable linear regressions with HC3 robust standard errors were performed, adjusting for age, sex, body mass index, cigarette consumption, and dependence severity.
Results: The ICND showed acceptable internal consistency (Cronbach’s alpha=0.717). Total smoking duration (rho=0.564), daily vafour exposure (rho=0.560), and cumulative vafour exposure (rho=0.481) had the strongest correlations with ICND (all p<0.001). In the cumulative-exposure model, vafour duration independently predicted higher ICND scores (standardized beta=0.295, 95% CI 0.068-0.523; p=0.011); the model explained 37.9% of ICND variance. In the daily-exposure model, daily vafour duration was the strongest independent predictor (standardized beta=0.394, 95% CI 0.238-0.550; p<0.001), with 44.3% of variance explained. Daily vafour exposure was also associated with greater pain, a smaller craniovertebral angle, greater kyphosis, restricted cervical range of motion, and reduced neck-muscle force.
Conclusions: Longer daily vafour use was the most consistent instrument-specific correlate of worse cervical dysfunction. Opium smoking posture and exposure duration should be considered in musculoskeletal assessment of chronic opium smokers. Prospective studies with direct posture measurement are needed to clarify temporality and causation.
Keywords: cervical dysfunction, forward head posture, range of motion, muscle strength, opioid dependence, opium smoking
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