Smoking and bone health, a deadly duo

Tobacco smoking creates an imbalance in bone turnover, that results in reduced bone mass.

Published: 04th May 2022 01:25 AM  |   Last Updated: 04th May 2022 09:52 PM   |  A+A-

Image used for representational purpose only. (File Photo)

Image used for representational purpose only. (File Photo)

Express News Service

HYDERABAD:  Tobacco smoking creates an imbalance in bone turnover, that results in reduced bone mass. The body’s normal bone repair process gets upset when nicotine enters the body. So, how exactly does smoking affect your bone health?

Reduced bone density 
People reach their peak bone density between the ages of 25 and 30, and then as they age, it gets worse from there. Tobacco smoking (in any form) slows down bone density. Rebuilding bone density is a slow process, and some of the damage may be irreversible. The heavier is the smoking habit, the longer it takes to build it up again.

Raises chances of developing Osteoporosis 
Calcium is essential for strong and healthy bones and smoking reduces calcium absorption in the body. Vitamin D helps bones to absorb calcium, but smoking interferes with this. The nicotine in cigarettes slows down the production of bone-producing cells (osteoblasts) and puts you at risk of Osteoporosis, a condition where bones become brittle and break. Smoking also decreases blood flow to the bones, delays the creation of bone-forming cells, and hastens the breakdown of oestrogen in the body impacting overall bone health.  

Vulnerability to fractures 
When nicotine deprives the bones of the nutrients, you are left with brittle and weaker bones So, smokers are more likely to suffer fractures and other severe injuries than non-smokers. Elderly smokers who are above 65 years are 30 - 40 %per cent more likely to fracture their hips. 

Increased soft tissue/sports injuries 
Smoking reduces the flow of blood and oxygen to the body’s soft tissues. It becomes difficult to gain muscle as a result of this. This affects your sports performance and leaves the smoker’s body with more aches and pains. Smokers are 1.5 times more likely to suffer from bursitis, tendinitis, rotator cuff tears, overuse injuries, sprains, and lower back discomfort.

Slow healing process 
Smoking limits the supply of oxygen and blood to the soft tissues and delays the production of bone-forming cells. So, the healing process slows down when you get injured and smokers’ injuries take a longer time to heal. Orthopaedic studies concluded that smoking negatively impacted bone healing. Poor prognosis for fracture healing is noticed in patients who smoke.

Negative effects post-surgery 
Smokers who keep smoking after Orthopaedic surgery often get poorer results than those who do not smoke or who stopped smoking before the treatment. Smoking slows down the healing process and the recovery time post-surgery. Infections and post-operative problems are seen more in smokers who undergo surgical procedures like bone fusion or muscle repair.  So, it is better to quit smoking first if you have to have a surgery.  


Smoking and Rheumatoid Arthritis (RA) 
Smoking is also linked to occurrence of low back pain and RA. Cigarette smokers have more amounts of inflammatory proteins known as cytokines in their bodies. These worsen the joint deterioration caused by RA.

Effects on different age groups 
Women who smoke have an earlier menopause than women who are non-smokers.

Among postmenopausal women and men of the same age, tobacco use is linked with increased bone loss. Premenopausal women too, who smoke, carry the risk of low bone status.

Researchers warn of a 20 per cent increased risk of a broken bone in the child’s first year if a woman smoked between 1-9 cigarettes/day during her pregnancy.

Children of parents who smoke (passive smokers) also showed signs of weakened bone health: reduced bone mass, low bone density and more low-energy fractures in their adulthood.  Cigarette smoking also causes inflammation of the gums and bones that surround and support the teeth (periodontal disease). This results in bone loss, and tooth loss.

If you are a smoker or trying to quit smoking, discuss with your orthopaedic surgeon about getting a bone density test to check for the risk of fractures or the onset of osteoporosis. 

The only way to decrease the adverse effects of smoking on bone health is to stop tobacco usage. Quit smoking if you want to protect your bones.

We know that smoking leads to heart, pulmonary problems and also cancer. But how many of us know that smoking can also injure your bones and soft tissues?


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