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Bridget F., 15, injured her back in 2013 while lifting sticks of harvested tobacco up to other workers in a barn in northeastern Kentucky: Im short, so I had to reach up, and I was reaching up and the tobacco plant bent over, and I went to catch it, and I twisted my back the wrong way. According to public health research, the impacts of repetitive strain injuries may be long-lasting and result in chronic pain and arthritis

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About half also met criteria for another drug use disorder (in addition to alcohol), and their average Fagerstrom nicotine dependence score was 5.2 (SD = 1.9) on a 0 to 10 scale (The Fagerstrom score is a common method to measure physical dependence on nicotine, and in this sample, average score was on the border between moderate and high dependence)