Osteoporotic fractures are a major public health problem in most developed countries and an increasing concern in much of the developing world. This healthcare burden will increase significantly worldwide over the next 20 years due to aging of the population. Smoking is a key lifestyle risk factor for bone loss and fractures that appears to be independent of other risk factors for fracture such as age, weight, sex and menopausal status. This review discusses the effects of smoking on bone health in pre-menopausal and post-menopausal women and men. Data from twin studies and the three main published meta-analyses are presented. Possible mechanisms by which smoking affects bone mass are reviewed. Despite smoking being a major lifestyle risk factor for osteoporosis, the mechanisms underlying smoking-associated bone loss and fracture risk remain poorly understood. The effect appears dose-dependent, and may be, at least partially, reversible. However, more work is required to confirm and characterize the reversibility of smoking-associated bone defects. Finally, strategies for quitting smoking are discussed. Encouragement of lifestyle alterations, including smoking cessation, should be a major component of any bone therapeutic programme.
Review Article| August 01 2007
The effects of smoking on bone health
Peter K. K. Wong;
Jemma J. Christie;
John D. Wark
†Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
‡Bone and Mineral Service, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
Correspondence: Professor John D. Wark (email firstname.lastname@example.org).
Search for other works by this author on:
- Views Icon Views
- Share Icon Share
- Cite Icon Cite
Peter K. K. Wong, Jemma J. Christie, John D. Wark; The effects of smoking on bone health. Clin Sci (Lond) 1 September 2007; 113 (5): 233–241. doi: https://doi.org/10.1042/CS20060173
Download citation file: