While most people know that smoking harms cardiovascular health and increases risk of cancer, fewer are aware that smoking negatively impacts bone health too.
Various clinical studies have shown a direct relationship between smoking and decreased bone density, as well as increased risk of fracture. In fact, because the evidence, linking smoking with increased fracture risk is so strong, smoking is one of the scientiﬁcally validated risk factors of bone mineral loss and fractures. Evidence shows that:
- Active / passive smoke during young age may increase risk of low bone
- The longer you smoke and the more cigarettes you consume daily, the greater your risk of fracture in old age.
- Older smokers, experience signiﬁcant bone loss.
- Fractures in smokers take longer to heal and may have more complications during healing than that in non-smokers.
- Women who smoke produce less estrogen (a sex hormone) and tend to experience menopause earlier, which may lead to increased bone
How does smoking weaken the bones?
It is well known that free radicals pose a major problem to our health. Nicotine in cigarettes increase free radical formation, leading to osteoporosis. Additionally, free radicals kill the new bone cells called osteoblasts and are also responsible for impeding hormone calcitonin that helps in bone building. Not just this, free radicals also increase levels of hormone cortisol that cause bone breakdown. Bones need a hormonal balance to stay healthy and smoking creates a huge imbalance.
What happens if bones become weaker?
Smoking causes osteoporosis and weakened bones, even in young people. Osteoporosis is associated with signiﬁcant pain, higher risks of fractures of hip, spine, shoulders, collarbone, ankle, wrist, etc and makes healing from injury or surgery signiﬁcantly more diﬃcult. Weak bones, if fractured, heal slowly or not heal at all. Smokers who heal are likely to have persistent pain and other complications post healing.
An analysis of 29 studies has shown that roughly one in eight hip fractures is attributed to cigarette smoking. Smokers lose bone at faster rates than non-smokers. Hip fracture risk among smokers is greater at all ages but rises signiﬁcantly from 17% at age 60 to 108% at age 90!
To improve bone health, quit smoking today
The best thing smokers can do to protect their bones is to quit smoking. At any age, this will help limit smoking-related bone loss and reduce fracture risk. Risks are lower in former / ex- smokers, suggesting that quitting reduces rate of bone loss.
If you’re a smoker quit smoking today, or if you are a passive inhaler of smoke due to someone around you smoking advise them to quit smoking to start on the path to healthier bones and a happier life.
- Smoking and Bone Health (NIAMS)
- Law MR, Hackshaw AK. A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major eﬀect. BMJ 1997; 315:841-6.
- Smoking and Musculoskeletal Health (AAOS)