Vin,   I answered this questioned on September 7th, on the StopSmokingConnection website.  For your convenience, I have copied that answer here for your review.     Sunday, September 07, 2008 Martin Cane, M.D.   vin,   Thanks for your question.   Given your age, it is very unlikely there is any association between your cigar smoking and your symptoms of back pain.  However the two symptoms you've described should be evaluated by your physician.   Back pain can be due to a long list of possibilities, mostly minor, and a few serious.  The decrease in your chest musculature could be due to lack of exercise and/or weight loss.    It's difficult to say what the cause is at this point.  Many more questions have to be asked by your doctor, as well as a physical examination, and he may request further testing.    So make an appointment to be seen in the near future to be sure that everything is OK.    Feel better.   Martin Cane, M.D.