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Smoking and Osteoporosis

Cigarette smoking was first identified as a risk factor for osteoporosis more than 20 years ago. Recent studies have shown a direct relationship between tobacco use and decreased bone density. Analyzing the impact of cigarette smoking on bone health is complicated. It is hard to determine whether a decrease in bone density is due to smoking itself or to other risk factors common among smokers. For example, in many cases smokers are thinner than nonsmokers, tend to drink more alcohol, may be less physically active, and have poor diets. Women who smoke also tend to have an earlier menopause than nonsmokers. These factors place many smokers at an increased risk for osteoporosis apart from their tobacco use.

In addition, most studies on the effects of smoking suggest that smoking increases the risk of having a fracture. Not all studies support these findings, but the evidence is mounting. For example:

§  The longer you smoke and the more cigarettes you consume, the greater your risk of fracture in old age.

§  Smokers who fracture may take longer to heal than nonsmokers and may experience more complications during the healing process.

§  Significant bone loss has been found in older women and men who smoke.

§  At least one study suggests that exposure to secondhand smoke during youth and early adulthood may increase the risk of developing low bone mass.

§  Compared with nonsmokers, women who smoke often produce less estrogen (a sex hormone) and tend to experience menopause earlier, which may lead to increased bone loss.

§  Quitting smoking appears to reduce the risk of low bone mass and fractures. However, it may take several years to lower a former smoker’s risk.



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