Back pain after smoking may be caused by aortic coarctation, or it may be caused by reasons unrelated to smoking, such as fractured ribs and muscle injuries. 1. Aortic coarctation: a disease in which the aortic wall is torn by smoking or other causes, thus separating the aortic cavity into a true cavity and a false cavity. The pain can be felt in the back and abdomen, and the two can cross over. The pain may also radiate to the back of the shoulder, or along the interscapular region to the chest, abdomen and lower limbs. 2. Rib fracture: It is mainly due to rib fracture caused by external impact. When the rib fracture of the patient’s back occurs, there can be severe pain locally, especially aggravated when moving the diseased limb, accompanied by obvious pressure pain. 3. Muscle injury: muscle injury may be caused by myositis, muscle ischemia, excessive pulling and other reasons. Due to the influence of a variety of factors, patients can appear diffuse or localized muscle pain in the back. Smoking back pain can also be seen in coronary heart disease and other causes, it is recommended to go to the hospital in a timely manner, follow the doctor’s instructions for treatment, to avoid delaying the condition.