The effects of smoking on bone health

Whatever your age, the effects of smoking on bone health can't be ignored.

The years from childhood until 30 years old are prime time for building bone mass. "If an adolescent is smoking, they will not develop maximum bone mass. They will end up with a smaller skeleton and less bone mass, compared to a nonsmoker", says Dr Primal Kaur, an osteoporosis specialist.

Smoking continues to affect bone health in your forties and fifties. Women begin to lose oestrogen in their later years, which is very important for bones. If you smoke, bone loss is more rapid - and there will be more complications, Kaur says.

Why is smoking so damaging to bone health?

" Nicotine and toxins in cigarettes affect bone health from many angles", Kaur says.

Cigarette smoke generates huge amounts of free radicals - molecules that attack and overwhelm the body's natural defences. The result is a chain reaction of damage throughout the body - including cells, organs and hormones involved in keeping bones healthy.

The toxins upset the balance of hormones (such as oestrogen) that bones need to stay strong. Your liver produces more oestrogen-destroying enzymes, which also leads to bone loss, says Kaur. "Smoking makes bone loss even worse in the menopausal years. It adds to the bone loss that's already occurring."

Smoking triggers other bone-damaging changes such as increased levels of the hormone cortisol, which leads to bone breakdown, says Kaur. "Research also suggests that smoking impedes the hormone calcitonin, which helps build bones - so that hormone can't do its job."

There's more: "Nicotine and free radicals kill the osteoblasts - the bone-making cells", she explains. "Smoking also damages blood vessels, so there is poor blood supply of oxygen. People who smoke have repeated fractures. Studies show that when a smoker suffers a fracture, they don't heal very well because of poor blood supply."

Because smoking damages blood vessels, it also damages nerves in toes and feet, which can lead to more falls and fractures. "Smokers have double the risk of having a fracture. Heavy smokers increase the risk of fracture even more", Kaur says.

If you stop smoking, is it possible to improve bone health?

"Bone building is a slow process, and it takes a long time to fix the damage, so some of the damage may be irreversible", Kaur says. "The heavier the smoker, the longer it will take to recover."

But there is hope. She points to one recent study, published in 2006 in the Journal of Women's Health: After one year without smoking, a group of postmenopausal women had improved bone density, compared with women who continued smoking.

How do you get started if you want to stop smoking?

Therapist Murray Dabbyhas helped many people through their addictions. He's a former smoker who has guided many to nicotine freedom. During his career he has seen people with the most die-hard habits stop smoking.