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June 2015

Quit Smoking for Better Bone Health

Lung cancer. Heart disease. Stroke. You probably already know that smoking can lead to these health hazards. But you may not be so quick to link the habit with bone health. Namely, osteoporosis—a condition in which your bones become weak and brittle. A recent study found smoking may be especially bad for men’s bones.

Man looking at unlit cigarette

An unhealthy habit

Researchers studied the bone health of more than 3,300 middle-aged and older adults. They specifically checked their bone mineral density. People with low bone density tend to have weaker bones. As a result, they are more likely to develop osteoporosis. They are also more likely to break a bone.

Many of the study participants were current or past smokers. Most of them also had chronic obstructive pulmonary disease, or COPD. This lung disease makes it hard for a person to breath.

Overall, smokers in the study had lower bone density. Men, in particular, were 55% more likely to have it. They were also more prone to vertebral fractures, or broken bones in the back. This link suggests smoking may well weaken bone health over time. Nicotine and other chemicals in tobacco smoke may affect how bone cells work. Smoking may also slow the healing process of broken bones.

Bone density testing

Most experts currently recommend screening for bone density only in women ages 65 and older. That’s because women are more likely to develop osteoporosis. They tend to have smaller bones. A drop in the hormone estrogen after menopause also lowers a woman’s bone density.

Men may be less likely to end up with osteoporosis. But they are not immune to it. What’s more, the disease can be even worse for them. It tends to strike at an older age. Older men who break a bone are less likely to recover from such an injury.

Some men should still talk with their doctors about a bone density screening. The National Osteoporosis Foundation advises all men age 70 and older to do so. Younger men who are at high risk for osteoporosis should also consider the test. For instance, discuss the screening with your doctor if you take certain medicine, such as a proton pump inhibitor for acid reflux disease. Some health problems can also make you more prone to osteoporosis. These include diabetes and prostate cancer.

To help boost bone health, eat foods rich in calcium and vitamin D. Avoid smoking and drinking. And most of all, exercise regularly. The best activities are those that put weight on your bones. These include walking, running, weightlifting, and dancing. One small study found greater bone density in men who got more physical activity when they were younger.


DXA: Bone Density Screening

The most common type of bone mineral density test is called DXA. That stands for dual-energy X-ray absorptiometry. This painless test works much like an X-ray.

With DXA, your doctor can measure the bone density at your hip and spine. The result is called a T-score. It’s calculated in standard deviation (SD) units. The score is obtained by comparing your bone density level with an ideal one based on a healthy 30-year-old adult. The levels are:

  • +1 or -1 SD, healthy

  • -1 to -2.5, low bone mass

  • -2.5 or below, osteoporosis


Are you at risk for osteoporosis? Take this assessment.



Online Medical Reviewer: Turley, Ray, BSN, MSN
Date Last Reviewed: 5/27/2015
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