The Effect of Cigarette Smoking on the Development of Osteoporosis and Related Fractures

, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pa.


Medscape General Medicine. 1999;1(3) 

In This Article


The available evidence indicates that chronic cigarette use has profound effects on bone health. These effects are cumulative and become apparent in postmenopausal women and in men older than 60 years. Older individuals who have a lifelong history of smoking have decreased BMD, are more susceptible to osteoporotic fractures at the spine and hip, and are more likely to have recurrent fractures. In adults of all ages, fractures take longer to heal -- and malunions or nonunions are more common--in patients who smoke. For some types of orthopaedic procedures, the surgical management may be modified in an attempt to compensate for the adverse effects of smoking on bone metabolism.