Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1993 Sep;83(9):1265–1270. doi: 10.2105/ajph.83.9.1265

Cigarette smoking and bone mineral density in older men and women.

K A Hollenbach 1, E Barrett-Connor 1, S L Edelstein 1, T Holbrook 1
PMCID: PMC1694953  PMID: 8363002

Abstract

OBJECTIVES. The association between cigarette smoking and bone mineral density was examined prospectively in a population-based study of older Caucasian men and women. METHODS. Smoking patterns were determined at a 1972-1974 baseline evaluation and, again, 16 years later when 544 men and 822 women had bone mineral density measurements taken. RESULTS. Men and women who were cigarette smokers at baseline demonstrated significantly reduced bone mineral density of the hip compared with nonsmokers. Baseline smoking was not associated with significantly lower bone density at non-hip sites. Women demonstrated a significant dose-response relationship between baseline smoking status at all hip sites measured. Both sexes exhibited significant dose-response relationships between hip bone mineral density and change in smoking status between baseline and follow-up, demonstrating that smoking cessation in later life was beneficial in halting bone density loss associated with smoking. CONCLUSIONS. Smoking was positively and significantly associated with decreased hip bone mineral density in old age. Bone loss associated with smoking would be expected to predict an increased risk of hip fracture in those who do not succumb earlier to another complication of tobacco use.

Full text

PDF
1265

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alderman B. W., Weiss N. S., Daling J. R., Ure C. L., Ballard J. H. Reproductive history and postmenopausal risk of hip and forearm fracture. Am J Epidemiol. 1986 Aug;124(2):262–267. doi: 10.1093/oxfordjournals.aje.a114384. [DOI] [PubMed] [Google Scholar]
  2. Aloia J. F., Cohn S. H., Vaswani A., Yeh J. K., Yuen K., Ellis K. Risk factors for postmenopausal osteoporosis. Am J Med. 1985 Jan;78(1):95–100. doi: 10.1016/0002-9343(85)90468-1. [DOI] [PubMed] [Google Scholar]
  3. Barrett-Connor E., Khaw K. T. Cigarette smoking and increased endogenous estrogen levels in men. Am J Epidemiol. 1987 Aug;126(2):187–192. doi: 10.1093/aje/126.2.187. [DOI] [PubMed] [Google Scholar]
  4. Criqui M. H., Barrett-Connor E., Austin M. Differences between respondents and non-respondents in a population-based cardiovascular disease study. Am J Epidemiol. 1978 Nov;108(5):367–372. doi: 10.1093/oxfordjournals.aje.a112633. [DOI] [PubMed] [Google Scholar]
  5. Friedman A. J., Ravnikar V. A., Barbieri R. L. Serum steroid hormone profiles in postmenopausal smokers and nonsmokers. Fertil Steril. 1987 Mar;47(3):398–401. [PubMed] [Google Scholar]
  6. Hemenway D., Colditz G. A., Willett W. C., Stampfer M. J., Speizer F. E. Fractures and lifestyle: effect of cigarette smoking, alcohol intake, and relative weight on the risk of hip and forearm fractures in middle-aged women. Am J Public Health. 1988 Dec;78(12):1554–1558. doi: 10.2105/ajph.78.12.1554. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Holló I., Gergely I., Boross M. Influence of heavy smoking upon the bone mineral content of the radius of the aged and effect of tobacco smoke on the sensitivity to calcitonin of rats. Aktuelle Gerontol. 1979 Aug;9(8):365–368. [PubMed] [Google Scholar]
  8. Horwitz R. I., Yu E. C. Problems and proposals for interview data in epidemiological research. Int J Epidemiol. 1985 Sep;14(3):463–467. doi: 10.1093/ije/14.3.463. [DOI] [PubMed] [Google Scholar]
  9. Jensen J., Christiansen C., Rødbro P. Cigarette smoking, serum estrogens, and bone loss during hormone-replacement therapy early after menopause. N Engl J Med. 1985 Oct 17;313(16):973–975. doi: 10.1056/NEJM198510173131602. [DOI] [PubMed] [Google Scholar]
  10. Khaw K. T., Tazuke S., Barrett-Connor E. Cigarette smoking and levels of adrenal androgens in postmenopausal women. N Engl J Med. 1988 Jun 30;318(26):1705–1709. doi: 10.1056/NEJM198806303182601. [DOI] [PubMed] [Google Scholar]
  11. Krall E. A., Dawson-Hughes B. Smoking and bone loss among postmenopausal women. J Bone Miner Res. 1991 Apr;6(4):331–338. doi: 10.1002/jbmr.5650060404. [DOI] [PubMed] [Google Scholar]
  12. Kreiger N., Kelsey J. L., Holford T. R., O'Connor T. An epidemiologic study of hip fracture in postmenopausal women. Am J Epidemiol. 1982 Jul;116(1):141–148. doi: 10.1093/oxfordjournals.aje.a113388. [DOI] [PubMed] [Google Scholar]
  13. Leino A., Impivaara O., Järvisalo J., Helenius H. Factors related to risk of osteoporosis in 50-year-old women. Calcif Tissue Int. 1991;49 (Suppl):S76–S77. doi: 10.1007/BF02555096. [DOI] [PubMed] [Google Scholar]
  14. Paganini-Hill A., Chao A., Ross R. K., Henderson B. E. Exercise and other factors in the prevention of hip fracture: the Leisure World study. Epidemiology. 1991 Jan;2(1):16–25. doi: 10.1097/00001648-199101000-00004. [DOI] [PubMed] [Google Scholar]
  15. Paganini-Hill A., Ross R. K., Gerkins V. R., Henderson B. E., Arthur M., Mack T. M. Menopausal estrogen therapy and hip fractures. Ann Intern Med. 1981 Jul;95(1):28–31. doi: 10.7326/0003-4819-95-1-28. [DOI] [PubMed] [Google Scholar]
  16. Rundgren A., Mellström D. The effect of tobacco smoking on the bone mineral content of the ageing skeleton. Mech Ageing Dev. 1984 Dec;28(2-3):273–277. doi: 10.1016/0047-6374(84)90027-7. [DOI] [PubMed] [Google Scholar]
  17. Seeman E., Melton L. J., 3rd, O'Fallon W. M., Riggs B. L. Risk factors for spinal osteoporosis in men. Am J Med. 1983 Dec;75(6):977–983. doi: 10.1016/0002-9343(83)90878-1. [DOI] [PubMed] [Google Scholar]
  18. Slemenda C. W., Hui S. L., Longcope C., Johnston C. C., Jr Cigarette smoking, obesity, and bone mass. J Bone Miner Res. 1989 Oct;4(5):737–741. doi: 10.1002/jbmr.5650040513. [DOI] [PubMed] [Google Scholar]
  19. Sparrow D., Beausoleil N. I., Garvey A. J., Rosner B., Silbert J. E. The influence of cigarette smoking and age on bone loss in men. Arch Environ Health. 1982 Jul-Aug;37(4):246–249. doi: 10.1080/00039896.1982.10667572. [DOI] [PubMed] [Google Scholar]
  20. Stevenson J. C., Lees B., Devenport M., Cust M. P., Ganger K. F. Determinants of bone density in normal women: risk factors for future osteoporosis? BMJ. 1989 Apr 8;298(6678):924–928. doi: 10.1136/bmj.298.6678.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Williams A. R., Weiss N. S., Ure C. L., Ballard J., Daling J. R. Effect of weight, smoking, and estrogen use on the risk of hip and forearm fractures in postmenopausal women. Obstet Gynecol. 1982 Dec;60(6):695–699. [PubMed] [Google Scholar]
  22. la Vecchia C., Negri E., Levi F., Baron J. A. Cigarette smoking, body mass and other risk factors for fractures of the hip in women. Int J Epidemiol. 1991 Sep;20(3):671–677. doi: 10.1093/ije/20.3.671. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES