In this review article, we examine the epidemiological evidence for the relationship between structural lumbar spine disease and smoking, obesity, and arteriosclerosis. According to the Medline analysis, there is insufficient evidence for an association between lumbar spine disorders and smoking or obesity. There are very few epidemiological studies that focus on the relationship between arteriosclerotic changes and structural lumbar spine disease. To conclude, to date there is insufficient evidence for a potential etiological role of smoking, arteriosclerosis, or body weight in structural lumbar spine disease.