Smoking puts your bones at risk
Larissa Melville completed her traineeship in the editorial team of . After studying biology at Ludwig Maximilians University and the Technical University of Munich, she first got to know digital media online at Focus and then decided to learn medical journalism from scratch.
More about the experts All content is checked by medical journalists.MunichSmoking damages the lungs and can cause cancer, as is well known. It also increases the risk of bone loss.
Osteoporosis is generally considered to be a women's disease. But that's wrong - men can also be affected. Because a decreased bone density can have different causes. It is true that the female hormone balance is often to blame for porous bones, but age or influenceable factors such as underweight or vitamin D deficiency can also be responsible. Smoking has also long been associated with decreased bone density. Elizabeth Regan, Assistant Professor at National Jewish Health, and her team wanted to know exactly how tobacco use affects bone density.
Measurement of bone density
To do this, the researchers determined the bone density of over 3,300 male and female smokers or ex-smokers with and without COPD using computed tomography. They then compared the measured values with a standard measure, that of the average bone density of a young adult. All study participants were between 45 and 80 years old and had smoked for at least ten pack-years. This is a unit that describes tobacco consumption: the number of cigarette packs consumed daily (content approx. 20 pieces) multiplied by the years of smoking. Ten pack-years is therefore, for example, a pack of cigarettes per day for ten years.
Broken bones from tobacco
The investigation showed that eleven percent of the subjects had normal bone density, 31 percent medium and 58 percent low. According to the authors of the study, smokers are at high risk of developing osteoporosis. "The male smokers even plagued themselves a little more often with a low bone density and fractures than the female," reports Regan to This is particularly interesting because men usually suffer from osteoporosis less often than women in old age.
Participants with severe COPD struggled with bad bones even more often: Over 80 percent of them had too low bone density. And even after factoring out factors such as ethnicity, age, weight, steroid use or smoking, the connection between COPD and porous bones remained.
In addition, the scientists found that the likelihood of osteoporosis increased with the level of tobacco consumption.
Screening for women and men
“Our results suggest that current and former smokers of both sexes should be screened for osteoporosis,” Regan says. It makes sense to have an examination from the early 50s. This way, bone diseases can be identified and treated at an early stage. This not only prevents broken bones, but also improves the quality of life and lowers health costs.
The German guideline for osteoporosis recommends routine bone density measurements for female smokers from the age of 60 and male smokers from the age of 70.
Mechanism still unknown
It is not yet known exactly why smoking damages the bones. Regan suspects, however: “Smoke and nicotine act directly on the blood vessels and worsen blood circulation. This may lead to a reduction in the factors that stimulate bone formation. ”In addition, smokers and COPD patients are often underweight. According to the expert, smoking also affects the endocrine system. “It reduces hormones like estrogen that stimulate bone formation. In patients with COPD, the chronic inflammation could also lead to lower bone density. "
Progressive bone loss
If the bone density decreases more and more, those affected suffer from osteoporosis. Even a slight fall can lead to a fracture. Older women are often affected - due to the falling estrogen level. The alpha and omega of protection against this metabolic disease are early preventive measures such as plenty of exercise, a good diet and no smoking.
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