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More than 2 00 000 families are included in tobacco farming in Brazil. In harvesting, baling, cutting wood among other activities the farmers are exposed to vicious position, physical effort, repetitive movements and vibrations. Thus, this study evaluated the prevalence and factors associated with cervical pain in tobacco farmers in southern Brazil.A cross-sectional study was carried out with a representative sample of 2469 tobacco farmers from the municipality of São Lourenço do Sul/RS/Brazil. Cervical pain was characterised by an adaptation of the Nordic Questionnaire for Musculoskeletal Symptoms. The multivariate analysis was performed by Poisson regression, following a hierarchical model.The prevalence of cervical pain in the last year was 7.4%, 9.1% for women and 6.2% for men. Work at intense or accelerated pace and green tobacco sickness in the last year were positively associated with cervical pain in both sexes. However, smoking and baling were risk factors among women, while older age, using heavy chainsaw and having suffered pesticide poisoning showed a risk among men.The prevalence of cervical pain is similar to that found in other studies in farmers, but risk activities are marked by the sexual division of labour and are related to ergonomic exposures. The study points to the need to deepen understanding about the role of nicotine exposure in musculoskeletal problems. The mechanisation of the harvest and the activities needed to heal the leaf could reduce cervical pain among smokers.