Smoking and Osteoporosis - A Guide to Stop Smoking

One effect of smoking which many people are unaware of is that of bone health. If you smoke then you increase your risk of a fracture and osteoporosis, which is a particular problem for women.

Why is this?

The hormone oestrogen protects women against osteoporosis but levels of this fall once a woman reaches the menopause. This leads to bones which are thinner, weaker and more likely to break. Plus a woman has smaller and lighter skeleton than that of a man so she is at a disadvantage to start with.

Our bones grow from childhood and reach their optimum mass once we reach the age of 30. Once past this age our bones start to lose density although this can be arrested if we undertake weight bearing exercise such as running.

So how does smoking affect your bone health?

If you start smoking when you are in your teens then this will prevent you from developing maximum bone density. The reason for this is that your teenage years are a time of growth and development in which your body undergoes many changes that also includes your bones. You should reach your optimum height and skeletal development at the end of this period but this can be restricted if you smoke.

The result is a smaller, lighter and potentially weaker skeleton which increases your risk of osteoporosis later on in life.

Affects of smoking on bone health

It’s the toxins present in cigarette smoke which cause all this damage. Cigarettes contain tobacco which releases a whole range of chemicals when burnt. These include nicotine and tar.

These toxins contain free radicals (molecules which attack the body’s defence systems) which then disrupt the balance of hormones, cells and organs that are responsible for healthy bones.

It is also responsible for the following:

  • Affects oestrogen levels which are crucial for bone density in women.
  • Increases cortisol production which results in bone loss and affects the workings of the hormone calcitonin, which helps to build healthy bones.
  • Reduces the blood supply to the bones which is vital for their health. This blood supply carries oxygen, nutrients and minerals to the bones which help to nourish them. However, smoking constricts the blood vessels (narrows them) which reduces the blood flow to the bones. And less nutrients means less well developed bones.
  • Destroys cells – osteoblasts - needed for bone production which affects their overall growth.
  • Means that fractures take longer to heal in a smoker than a non-smoker. Plus there is a greater risk of complications for a smoker during this process.
  • Can increase the risk of rheumatoid arthritis, in women, after the menopause.
  • Damages the nerves in the feet and toes which affects circulation and increases the risk of a fall and a fracture. And this is even more of a problem if it happens when the person is older.

And, there is the risk of reduced bone density from passive smoking. If you have been exposed to someone else’s smoke when you were young then this increases your risk of reduced bone mass later on in life.

And, there is some evidence to show that exposure to passive smoking when you are young can lead to back pain in adulthood. Smoking restricts the blood supply to the spine which compromises its development.

If you are a woman then be aware that smoking increases the risk of an early menopause which unfortunately means early bone loss, and the risk of a fracture.

None of this is good news but these effects can be reversed as long as you stop smoking. It is the case that the longer you have been smoking the greater the damage and the longer it will take to recover but it is possible.

For more information visit our Stopping Smoking section.

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