Tobacco
Can smoking and/or the use of tobacco products harm my bones?
It is alarming that approximately 1 in 8 hip fractures
(broken hips) in women are caused by long-term cigarette use (more
than 1 pack a day for more then 5 years) or current use of tobacco
products. Smoking is also a major risk factor for hip fracture in
men. In addition, the healing process following hip fracture is slower
among smokers than non-smokers.
How does smoking harm my bones?
More research is needed to fully understand the mechanism of the action
of smoking on bone. However, it appears that smoking has direct toxic
effects on the cells that make bone called osteoblasts. There are also
certain factors associated with smoking that may contribute to increased
bone loss and lower bone mass. A healthy body weight and weight-bearing
exercise are important to build bone mass in youth and maintain it
in adulthood. However, smokers tend to be thinner and exercise less
than non-smokers resulting in less weight bearing on their bones. In
addition, smoking reduces estrogen levels in women, the female hormone
that protects the bones. Women who smoke often experience an earlier
menopause (the permanent loss of menstrual periods) than non-smokers.
An earlier menopause results in a woman having a longer period of time
without estrogen.
How does smoking affect my bones over a lifetime?
Smoking or tobacco use during the growing years can prevent you from
reaching your peak bone mass. Peak bone mass, defined as the maximum
bone density (thickness) you will ever have, is reached between 18
and 25 years of age. It is a wise choice not to smoke or use tobacco
in youth and young adulthood because if you build larger and heavier
bones; you are less likely to develop osteoporosis later in life. At
menopause, all women lose bone mass rapidly and smoking will lead to
even greater losses. Smoking may also decrease the effectiveness of
estrogen therapy or hormone replacement therapy in preventing bone
loss. The age-related bone loss that occurs later in life in both men
and women also appears to be accelerated among smokers.
Individuals with a history of smoking more than 1 pack of cigarettes
per day for more than 5 years or those who currently use tobacco products
are at risk for osteoporosis. Heavier smokers have lower bone density
and a higher risk for fracture than nonsmokers or light smokers. In
addition, current cigarette smoking is an independent risk factor for
hip fracture; that means smokers are at an increased risk for hip fracture
even when their bone density is normal. A hip fracture is a debilitating
bone break that tends to occur in the senior years and is more common
among smokers. Men tend to have greater problems than women after suffering
a hip fracture. The likelihood that a man will return to the fully
independent lifestyle he had prior to a hip fracture is lower
than it is for a woman. In fact, men are at greater risk of dying in
the year following a hip fracture than are women.
What can a smoker do to reduce the risk for osteoporosis?
- Quit smoking! If you are a smoker and decide to continue to smoke,
you are clearly taking the chance of developing osteoporosis and
may be increasing your risk for fracture. The good news is that
the sooner you quit smoking, the better. Quitting smoking is an
important way to reduce your fracture risk. For example, women
who stop smoking can cut their hip fracture risk in half after
only 5 years.
For more information about how you can quit smoking
or using tobacco products;call Smoker's Quitline at 1-866-697-8487
(1-866-NY-QUITS)or click on The New York State Smoker's Quitsite http://www.nysmokefree.com/
- Find out if a bone density test (BMD
test) is appropriate for you. If you are a smoker don't
let osteoporosis sneak up on you, find out if a BMD test
is appropriate for you. A BMD test can measure the density
of your bones and detect osteoporosis before a bone breaks.
Smoking is such an important risk factor for osteoporosis
that women who currently smoke or have a recent history
of smoking more than 1 pack per day should have a bone
density test (BMD test) at the time of menopause. Men who
are current or long-term smokers should speak to their
medical professional to find out when a BMD test is recommended.
- Identify and reduce your personal risk factors for osteoporosis.
It is also important to assess other risk factors for osteoporosis
(besides smoking) by using the appropriate NYSOPEP Osteoporosis
Risk Assessments. See "Osteoporosis
Risk Assessment for Postmenopausal Women", for "Premenopausal
Women" or "for
Men". Risk assessment should increase the awareness
of your potential for osteoporosis, identify risk factors that
you can change, and motivate you to discuss your concerns with
your medical professional.
- Practice bone healthy actions. Bone healthy actions should
begin in childhood and continue throughout your lifetime. However,
it's never too late to take the actions to promote healthy
bones.
What are bone healthy actions?
In addition to not smoking and avoiding tobacco products,
you can take these actions to help build strong bones in youth
and maintain bone mass in adulthood:
- Eat a well-balanced diet and get adequate calcium
and vitamin D.
- Get moving! Participate in regular exercise. An ideal regimen includes
weight-bearing, muscle strengthening, postural and balance
exercise
- Limit your alcohol intake
- Avoid excessive dieting and excessive thinness
- Consult your medical professional to determine and treat
the cause if you are a premenopausal woman with infrequent
menstrual periods
- Taking safety precautions to protect your bones and prevent
falls
What if I am diagnosed with osteoporosis?
Treatment of osteoporosis should always include bone healthy
actions. However, if osteoporosis is diagnosed, these important
steps are often not enough. Medication may be needed to stop
further bone loss or fractures. For more information see "FDA-Approved
Medications for Osteoporosis Prevention and/or Treatment".
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