Current Osteoporosis Reports

, Volume 13, Issue 5, pp 302–309 | Cite as

Skeletal Effects of Smoking

  • Natalie E. Cusano
Therapeutics and Medical Management (E Shane and R Adler, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Therapeutics and Medical Management


Smoking is a leading cause of preventable death and disability. Smoking has long been identified as a risk factor for osteoporosis, with data showing that older smokers have decreased bone mineral density and increased fracture risk compared to nonsmokers, particularly at the hip. The increase in fracture risk in smokers is out of proportion to the effects on bone density, indicating deficits in bone quality. Advanced imaging techniques have demonstrated microarchitectural deterioration in smokers, particularly in the trabecular compartment. The mechanisms by which smoking affects skeletal health remain unclear, although multiple pathways have been proposed. Smoking cessation may at least partially reverse the adverse effects of smoking on the skeleton.


Smoking Skeleton Bone Osteoporosis Fractures 


Compliance with Ethics Guidelines

Conflict of Interest

The author of this paper declares she has no conflicts of interest.

Human and Animal Rights and Informed Consent

This article contains no studies with human or animal subjects performed by the author.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Medicine, Division of EndocrinologyColumbia University Medical CenterNew YorkUSA

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