The effects of smoking on bone metabolism

Yoon, V.; Maalouf, N. M.; Sakhaee, K.

doi:10.1007/s00198-012-1940-y

Cited by 268Bone health and osteoporosis researchBone Metabolism and DiseasesSmoking Behavior and Cessation

The effects of smoking on bone metabolism

Yoon, V., Maalouf, N. M., Sakhaee, K.·2012·Osteoporosis International

DOI 10.1007/s00198-012-1940-y

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Abstract

Osteoporosis is a common, morbid and costly disorder characterized by deterioration in bone strength. Cigarette smoking is associated with reduced bone mineral density (BMD) and increased fracture risk. There are basic, clinical, and observational studies that define several of the underlying pathophysiologic mechanisms that predispose smokers to bone loss. Such mechanisms include alterations in calciotropic hormone metabolism and intestinal calcium absorption, dysregulation in sex hormone production and metabolism, alterations in adrenal cortical hormone metabolism and in the receptor activator of nuclear factor kappa-B (RANK), receptor activator of nuclear factor kappa-B ligand (RANKL), and osteoprotegerin (OPG) system (RANK-RANKL-OPG system), and direct cellular effects of cigarette use on bone cells. In addition, there is evidence of reversibility in the aforementioned mechanisms with smoking cessation. In summary, cigarette smoking is a reversible risk factor for osteoporosis and osteoporotic fractures through diverse pathophysiologic mechanisms.

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In men, the mechanism of aromatase inhibition was reported, suppressing production of estradiol from testosterone.
“Similar to women, the mechanism of aromatase inhibition was reported in men; this mechanism suppressed production of estradiol from testosterone [16].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [16]
The low vitamin D levels in smokers may be related to decreased intake of vitamin D or induction of the liver enzyme that enhances hepatic metabolism of vitamin D metabolites, or via suppression of parathyroid hormone (PTH) release.
“which may be related to the decreased intake of vitamin D or the induction of the liver enzyme that enhances hepatic metabolism of vitamin D metabolites [5], or via suppression of parathyroid hormone (PTH) release [16].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [16]
Bone is dynamic tissue undergoing continuous remodeling via bone formation and resorption.
“Bone is dynamic tissue undergoing continuous remodeling via bone formation and resorption [16, 68].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [16]
The activities of osteoblasts and osteoclasts are regulated by several factors, including the RANKL-RANK-OPG pathway, estradiol, various cytokines, and calciotropic hormones.
“The activities of both are regulated by several factors, including the RANKL-RANK-OPG pathway, estradiol, various cytokines, and calciotropic hormones [16, 45, 69].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [16]
Nicotine has an inhibitory effect on osteogenesis and on angiogenesis that play key roles in bone metabolism.
“Nicotine has an inhibitory effect on osteogenesis and on angiogenesis that play key roles in bone metabolism [16].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [16]

After bone reaches peak mass, it undergoes constant remodeling via resorption followed by formation.
“After bone reaches peak mass, it undergoes constant remodeling via resorption followed by formation [16, 68].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [16]
Laboratory studies found rats exposed to smoke inhalation had higher levels of RANKL/OPG ratio compared to control rats not exposed to smoke.
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From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [16]
Smoking downregulates vitamin D serum levels and inhibits the production of parathyroid hormone.
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From An Overlooked Bone Metabolic Disorder: Cigarette Smoking-Induced Osteoporosis (2022) · cites this paper as [44]
Cigarette smoking is one of the main social risk factors for developing metabolic bone diseases such as osteoporosis, Paget's disease, osteomalacia, and diabetic osteopathy, which compromise bone remodeling through altered bone formation by osteoblasts, increased bone degradation by osteoclasts, or both.
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From Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic (2021) · cites this paper as [14]

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Short-term effects of smoking on the pharmacokinetic profiles of micronized estradiol in postmenopausal women
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Relationships Between Intestinal Calcium Absorption, Serum Vitamin D Metabolites and Smoking in Postmenopausal Women
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Cigarette Smoking and Endogenous Sex Hormones in Postmenopausal Women
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Effect of Tobacco Consumption on Bone Mineral Density in Healthy Young Males
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Interaction between current smoking, leanness, and physical inactivity in the prediction of hip fracture
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Effects of Cigarette-Smoking on Bone Mass as Assessed by Dual-Energy X-ray Absorptiometry and Ultrasound
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Nicotine and lipopolysaccharide stimulate the formation of osteoclast-like cells by increasing macrophage colony-stimulating factor and prostaglandin E2 production by osteoblasts
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Cigarette smoking, steroid hormones, and bone mineral density in young women
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The short-term effects of conjugated estrogen on bone turnover in older women
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Uncoupled angiogenesis and osteogenesis in nicotine-compromised bone healing
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The influence of thinness and smoking on bone loss and response to hormone replacement therapy in early postmenopausal women
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The Effects of Smoking on Bone Mass and the Rates of Bone Loss Among Elderly Japanese-American Men
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Impact of Smoking Cessation on Bone Mineral Density in Postmenopausal Women
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Risk Factors for Hip Fracture in Older Home Care Clients
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Impact of smoking on bone mineral density and bone metabolism in elderly men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study
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Diet, smoking and anthropometric indices and postmenopausal bone fractures: a prospective study
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Negative effects of nicotine on bone-resorbing cytokines and bone histomorphometric parameters in male rats
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Smoking predicts incident fractures in elderly men: Mr OS Sweden
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Cigarette Smoking, Body Mass and Other Risk Factors for Fractures of the Hip in Women
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Nicotine induced proliferation and cytokine release in osteoblastic cells
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Evaluation of the effects of cigarette smoking on testosterone levels in adult men
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Calcium homeostasis: Reassessment of the actions of parathyroid hormone
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Early smoking is associated with peak bone mass and prevalent fractures in young, healthy men
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Vitamin D metabolism and calcium absorption
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Serum parathyroid hormone (PTH) levels in smokers and non-smokers. The fifth Tromsø study
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A Cross-Sectional Study of Smoking and Bone Mineral Density in Premenopausal Parous Women: Effect of Body Mass Index, Breastfeeding, and Sports Participation
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Demographic, dietary, and serum factors and parathyroid hormone in the National Health and Nutrition Examination Survey
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Effects of smoking cessation or reduction on hormone profiles and bone turnover in postmenopausal women
Oncken, C., Prestwood, K., Cooney, J. L., Unson, C., Fall, P., Kulldorff, M., & Raisz, L. G. (2002) · Nicotine & Tobacco Research · doi:10.1080/1462220021000018399 · Cited by 53 · see citing works
A simple clinical score for estimating the long-term risk of fracture in post-menopausal women
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Effect of smoking on concentrations of receptor activator of nuclear factor κ B ligand and osteoprotegerin in human gingival crevicular fluid
Tang, T. H., Fitzsimmons, T. R., & Bartold, P. M. (2009) · Journal of Clinical Periodontology · doi:10.1111/j.1600-051x.2009.01444.x · Cited by 52 · see citing works
NICOTINE‐INDUCED STIMULATION OF STEROIDOGENESIS IN ADRENOCORTICAL CELLS OF THE CAT
Rubin, R. N., & Warner, W. A. (1975) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.1975.tb07371.x · Cited by 48 · see citing works
Cigarette smoke inhibits osteogenic differentiation and proliferation of human osteoprogenitor cells in monolayer and three-dimensional collagen gel culture
Liu, X. D., Zhu, Y., Umino, T., Spurzem, J. R., Romberger, D. J., Wang, H., Reed, E. C., & Rennard, S. I. (2001) · Journal of Laboratory and Clinical Medicine · doi:10.1067/mlc.2001.113066 · Cited by 45 · see citing works
Raised serum levels of interleukin-8 and interleukin-18 in relation to bone metabolism in endogenous Cushing's syndrome
Kristo, C., Godang, K., Ueland, T., Lien, E., Aukrust, P., Froland, S., & Bollerslev, J. (2002) · European Journal of Endocrinology · doi:10.1530/eje.0.1460389 · Cited by 45 · see citing works
Cigarette smoke extract inhibits chemotaxis and collagen gel contraction mediated by human bone marrow osteoprogenitor cells and osteoblast-like cells
Liu, X., Kohyama, T., Kobayashi, T., Abe, S., Kim, H. J., Reed, E. C., & Rennard, S. I. (2003) · Osteoporosis International · doi:10.1007/s00198-002-1350-7 · Cited by 43 · see citing works
Impact of Passive Smoking on the Bones of Rats
Ajiro, Y., Tokuhashi, Y., Matsuzaki, H., Nakajima, S., & Ogawa, T. (2010) · Orthopedics · doi:10.3928/01477447-20100104-14 · Cited by 43 · see citing works
Ovarian function and cigarette smoking
Whitcomb, B. W., Bodach, S. D., Mumford, S. L., Perkins, N. J., Trevisan, M., Wactawski‐Wende, J., Liu, A., & Schisterman, E. F. (2010) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.2010.01131.x · Cited by 41 · see citing works
Evaluation of easily measured risk factors in the prediction of osteoporotic fractures
Bensen, R., Adachi, J. D., Παπαϊωάννου, Α., Ioannidis, G., Olszynski, W. P., Sebaldt, R. J., Murray, T. M., Josse, R. G., Brown, J. P., Hanley, D. A., et al. (2005) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-6-47 · Cited by 40 · see citing works
Cigarette smoking alters hepatic estrogen metabolism in men: Implications for atherosclerosis
Michnovicz, J. J., Hershcopf, R. J., Haley, N. J., Bradlow, H. L., & Fishman, J. (1989) · Metabolism · doi:10.1016/0026-0495(89)90213-8 · Cited by 40 · see citing works
Cigarette smoke inhalation modulates gene expression in sites of bone healing: a study in rats
Giorgetti, A. P. O., César Neto, J. B., Ruiz, K. G. S., Casati, M. Z., Sallum, E. A., & Nociti, F. H. (2010) · Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology · doi:10.1016/j.tripleo.2010.02.029 · Cited by 39 · see citing works
Short and long-term effects of smoking on cortisol in older adults
Direk, N., Newson, R. S., Hofman, A., Kirschbaum, C., & Tiemeier, H. (2011) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2011.02.007 · Cited by 38 · see citing works
Effect of testosterone, raloxifene and estrogen replacement on the microstructure and biomechanics of metaphyseal osteoporotic bones in orchiectomized male rats
Stuermer, E. K., Sehmisch, S., Tezval, M., Tezval, H., Rack, T., Boekhoff, J., Wuttke, W., Herrmann, T. R. W., Seidlova-Wuttke, D., & Stuermer, K. M. (2009) · World Journal of Urology · doi:10.1007/s00345-009-0373-5 · Cited by 37 · see citing works
History of fractures as predictor of subsequent hip and nonhip fractures among older Mexican Americans.
Ojo, F., Snih, S. A., Ray, L. A., Raji, M. A., & Markides, K. S. (2007) · PubMed Central · Cited by 34 · see citing works
Association between passive smoking in adulthood and phalangeal bone mineral density: results from the KRAM study—the Danish Health Examination Survey 2007–2008
Holmberg, T., Bech, M., Curtis, T., Juel, K., Grønbæk, M., & Brixen, K. (2011) · Osteoporosis International · doi:10.1007/s00198-010-1506-9 · Cited by 34 · see citing works
Timing and risk factors for clinical fractures among postmenopausal women: a 5-year prospective study
van Geel, A. C., Geusens, P., Nagtzaam, I. F., Schreurs, C. M. J. R., van der Voort, D. J. M., Rinkens, P. E. L. M., Kester, A. D. M., & Dinant, G. (2006) · BMC Medicine · doi:10.1186/1741-7015-4-24 · Cited by 34 · see citing works
Risk factors for pelvis fracture in older persons.
Kelsey, J., Prill, M., Keegan, T., Quesenberry, C., & Sidney, S. (2005) · American Journal of Epidemiology · doi:10.1093/aje/kwi295 · Cited by 33 · see citing works
Ex-smokers and risk of hip fracture.
Forsén, L., Bjartveit, K., Bjørndal, A., Edna, T., Meyer, H. E., & Schei, B. (1998) · American Journal of Public Health · doi:10.2105/ajph.88.10.1481 · Cited by 30 · see citing works
Determinants of forearm bone density in premenopausal women: a study in one general practice.
Cox, M. L., Khan, S. A., Gau, D., Cox, S. A., & HODKINSON, H. M. (1991) · Europe PMC (PubMed Central) · Cited by 26 · see citing works
Twenty-four-hour urinary-free cortisol in premenopausal cigarette smokers and nonsmokers
Yeh, J., & Barbieri, R. L. (1989) · Fertility and Sterility · doi:10.1016/s0015-0282(16)53177-x · Cited by 26 · see citing works
Sociodemographic factors associated with calcium intake in premenopausal women: a cross-sectional study
Winzenberg, T. M., Riley, M. D., Frendin, S., Oldenburg, B. F., & Jones, G. (2005) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602105 · Cited by 23 · see citing works
Smoking status as a predictor of hip fracture risk in postmenopausal women of northwest Texas.
Jenkins, M., & Denison, A. (2008) · PubMed Central · Cited by 23 · see citing works
Serum levels of testosterone and gonadotrophins with respect to smoking status and genetic polymorphism of GSTT1
Saadat, M. (2009) · Molecular Biology Reports · doi:10.1007/s11033-008-9319-z · Cited by 14 · see citing works
Over-the-counter nicotine replacement therapy for everyone: Is it the best solution?
Döme, P. (2011) · Medical Hypotheses · doi:10.1016/j.mehy.2011.08.045 · Cited by 3 · see citing works
Impact of Smoking on Bone Mineral Density in Elderly Men: The Fujiwara-kyo Osteoporosis Risk in Men (Formen) Study
Tamaki, J., Iki, M., Fujita, Y., Kouda, K., Yura, A., Kadowaki, E., Sato, Y., Moon, J.-S., Tomioka, K., Okamoto, N., et al. (2010) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2010.01.028 · Cited by 2 · see citing works
PMS54 GAP BETWEEN PATIENT-REPORTED ESTIMATION ON FRACTURE RISK AND THE WHO ASSESSMENT TOOL (FRAX®) IN POSTMENOPAUSAL OSTEOPOROSIS
Péntek, M., Horváth, C., Érsek, K., Baji, P., Bors, K., Csupor, E., Furi, J., Hacsuncz, M., Horváth, B., Kárpáti, S., et al. (2010) · Value in Health · doi:10.1016/s1098-3015(11)72207-0 · Cited by 1 · see citing works

Flagged first, then by citations

Sorted by citations

Degenerative Cervical Myelopathy
Nouri, A., Tetreault, L. A., Singh, A., Karadimas, S. K., & Fehlings, M. G. (2015) · Spine · doi:10.1097/brs.0000000000000913 · Cited by 950 · see citing works
Optimizing Bone Health in Children and Adolescents
Golden, N. H., Abrams, S. A., COMMITTEE ON NUTRITION, Daniels, S. R., Abrams, S. A., Corkins, M. R., de Ferranti, S. D., Golden, N. H., Magge, S. N., & Schwarzenberg, S. J. (2014) · PEDIATRICS · doi:10.1542/peds.2014-2173 · Cited by 497 · see citing works
The Key Role of the Blood Supply to Bone
Marenzana, M., & Arnett, T. R. (2013) · Bone Research · doi:10.4248/br201303001 · Cited by 369 · see citing works
Skeletal Blood Flow in Bone Repair and Maintenance
Tomlinson, R. E., & Silva, M. J. (2013) · Bone Research · doi:10.4248/br201304002 · Cited by 299 · see citing works
A look behind the scenes: the risk and pathogenesis of primary osteoporosis
Hendrickx, G., Boudin, E., & Hul, W. V. (2015) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2015.48 · Cited by 289 · see citing works
Smoking increases the risk of infectious diseases: A narrative review
Jiang, C., Chen, Q., & Xie, M. (2020) · Tobacco Induced Diseases · doi:10.18332/tid/123845 · Cited by 266 · see citing works
The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms
Al-Bashaireh, A. M., Haddad, L. G., Weaver, M., Chengguo, X., Kelly, D. L., & Yoon, S. (2018) · Journal of Osteoporosis · doi:10.1155/2018/1206235 · Cited by 209 · see citing works
“Low 25-hydroxy vitamin D (25-OH-D) and 1, 25-OH2-D in smokers were reported in several studies [20–27], which may be related to the decreased intake of vitamin D or the induction of the liver enzyme that enhances hepatic metabolism of vitamin D metabolites [5], or via suppression of parathyroid hormone (PTH) release […”
BackgroundInfluential
Bone Metastasis of Breast Cancer
Tahara, R. K., Brewer, T. M., Theriault, R. L., & Ueno, N. T. (2019) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-20301-6_7 · Cited by 174 · see citing works
Cigarette smoking and musculoskeletal disorders
Abate, M. (2013) · Muscles Ligaments and Tendons Journal · doi:10.11138/mltj/2013.3.2.063 · Cited by 158 · see citing works
Critical issues and current challenges in osteoporosis and fracture prevention. An overview of unmet needs
Lems, W. F., & Raterman, H. G. (2017) · Therapeutic Advances in Musculoskeletal Disease · doi:10.1177/1759720x17732562 · Cited by 152 · see citing works
Secondary Osteoporosis and Metabolic Bone Diseases
Sobh, M., Abdalbary, M., Elnagar, S., Nagy, E., Elshabrawy, N. A., Abdelsalam, M., Asadipooya, K., & El-Husseini, A. A. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11092382 · Cited by 160 · see citing works
“It has direct harmful effects on osteogenesis and bone blood flow [457].”
Background
Diagnosis and Management of Osteoporosis.
Jeremiah, M. P., Unwin, B., Greenawald, M. H., & Casiano, V. E. (2015) · PubMed · Cited by 130 · see citing works
Update on the role of bone turnover markers in the diagnosis and management of osteoporosis: a consensus paper from The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), International Osteoporosis Foundation (IOF), and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
Bhattoa, H. P., Vasikaran, S. D., Trifonidi, I., Kapoula, G., Lombardi, G., Jørgensen, N. R., Pikner, R., Miura, M., Chapurlat, R. D., Hiligsmann, M., et al. (2025) · Osteoporosis International · doi:10.1007/s00198-025-07422-3 · Cited by 130 · see citing works
Osteoporosis and fracture risk in people with schizophrenia
Kishimoto, T., Binder, M. D., Carlson, H. E., Manu, P., & Correll, C. U. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328355e1ac · Cited by 116 · see citing works
“Mechanisms include alterations in calciotropic hormone metabolism, intestinal calcium absorption, sex hormone regulation, adrenal cortical hormone metabolism, and the various receptor activators [52].”
Background
Smoking and Dental Implants: A Systematic Review and Meta-Analysis
Mustapha, A., Salame, Z., & Chrcanovic, B. R. (2021) · Medicina · doi:10.3390/medicina58010039 · Cited by 120 · see citing works
“Several pathophysiologic mechanisms that predispose smokers to bone loss have already been identified, with an inhibitory effect on osteogenesis and negative impact on bone metabolism [23].”
Background
Cigarette smoking and musculoskeletal disorders
Abate, M., Vanni, D., Pantalone, A., & Salini, V. (2019) · Muscle Ligaments and Tendons Journal · doi:10.32098/mltj.02.2013.03 · Cited by 111 · see citing works
Emerging factors affecting peri‐implant bone metabolism
Ínsua, Á., Galindo‐Moreno, P., Miron, R. J., Wang, H., & Monje, A. (2023) · Periodontology 2000 · doi:10.1111/prd.12532 · Cited by 114 · see citing works
Two‐year outcomes on bone density and fracture incidence in patients with T2DM randomized to bariatric surgery versus intensive medical therapy
Maghrabi, A. H., Wolski, K., Abood, B., Licata, A. A., Pothier, C. E., Bhatt, D. L., Nissen, S. E., Brethauer, S. A., Kirwan, J. P., Schauer, P. R., et al. (2015) · Obesity · doi:10.1002/oby.21150 · Cited by 106 · see citing works
“Smoking is identified as a risk factor for decreased BMD and fractures in the general population but the exact mechanism is not well understood; studies of similar effect in patients undergoing bariatric surgery are limited (19).”
Background
Nicotine and Tobacco as Substances of Abuse in Children and Adolescents
Siqueira, L. M., Ryan, S. A., Gonzalez, P. K., Patrick, S. W., Quigley, J. M., & Walker, L. R. (2016) · PEDIATRICS · doi:10.1542/peds.2016-3436 · Cited by 100 · see citing works
An Association Between Abnormal Bone Turnover, Systemic Inflammation, and Osteoporosis in Patients With Chronic Pancreatitis: A Case-Matched Study
Duggan, S. N., Purcell, C., Kilbane, M. T., O’Keane, M., McKenna, M. J., Gaffney, P. R., Ridgway, P. F., Boran, G. P., & Conlon, K. C. (2015) · The American Journal of Gastroenterology · doi:10.1038/ajg.2014.430 · Cited by 91 · see citing works
Glucocorticoids, Inflammation and Bone
Güler-Yüksel, M., Hoes, J. N., Bultink, I. E. M., & Lems, W. F. (2018) · Calcified Tissue International · doi:10.1007/s00223-017-0335-7 · Cited by 91 · see citing works
“alterations in calcitropic hormones, and decreased intestinal calcium absorption [109, 110], and indirect negative effects on bone due to more inflammatory activity and less response to anti-inflammatory treatment in smoking patients with chronic rheumatic inflammatory diseases compared to non-smoking patients.”
Smoking, smoking cessation, and fracture risk in elderly women followed for 10 years
Thorin, M., Wihlborg, A., Åkesson, K. S., & Gerdhem, P. (2015) · Osteoporosis International · doi:10.1007/s00198-015-3290-z · Cited by 84 · see citing works
“Descriptive statistics (median, 25th and 75th percentile) were used to describe smoking habits; number of fractures; and weight, height, BMI, and BMD. Pack-years were used to describe the amount that an individual had smoked until the age of 75 years.”
BackgroundInfluential
Risk factors for osteoporosis in inflammatory bowel disease patients
Lima, C. A. (2015) · World Journal of Gastrointestinal Pathophysiology · doi:10.4291/wjgp.v6.i4.210 · Cited by 83 · see citing works
Musculoskeletal Disorders in Chronic Obstructive Pulmonary Disease
Cielen, N., Maes, K., & Gayan‐Ramirez, G. (2014) · BioMed Research International · doi:10.1155/2014/965764 · Cited by 83 · see citing works
“Twenty percent of the world population smokes cigarettes [32] (http://www.”
Background
Implant‐Supported Immediately Loaded Fixed Full‐Arch Dentures: Evaluation of Implant Survival Rates in a Case Cohort of up to 7 Years
Niedermaier, R., Stelzle, F., Riemann, M., Bolz, W., Schuh, P. L., & Wachtel, H. C. (2016) · Clinical Implant Dentistry and Related Research · doi:10.1111/cid.12421 · Cited by 81 · see citing works
“The negative effects of smoking on bone metabolism are well described in literature.(54) Contrary to that, other studies did not find a correlation between smoking and implant loss.”
Result
Relationship between antipsychotic medication, serum prolactin levels and osteoporosis/osteoporotic fractures in patients with schizophrenia: a critical literature review
Binder, M. D., Detraux, J., & Stubbs, B. (2016) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2016.1167873 · Cited by 79 · see citing works
“between bone resorption and formation.[33,35,36,38,39,47] Sex steroid hormones, estrogens and testosterones, play”
Background
Associations of Smoking and Alcohol and Coffee Intake with Fracture and Bone Mineral Density: A Mendelian Randomization Study
Yuan, S., Michaëlsson, K., Wan, Z., & Larsson, S. C. (2019) · Calcified Tissue International · doi:10.1007/s00223-019-00606-0 · Cited by 77 · see citing works
Osteoporosis in Chronic Obstructive Pulmonary Disease
Sarkar, M. S., Bhardwaj, R., Madabhavi, I., & Khatana, J. (2015) · Clinical Medicine Insights Circulatory Respiratory and Pulmonary Medicine · doi:10.4137/ccrpm.s22803 · Cited by 80 · see citing works
Osteoporosis and cardiovascular disease: a review
Azeez, T. A. (2022) · Molecular Biology Reports · doi:10.1007/s11033-022-08088-4 · Cited by 76 · see citing works
“Interestingly, it has been reported that smoking cessation can lead to the reversal of its impact on bone mineral density [35].”
Background
Modifiable risk factors for bone health & fragility fractures
Wilson-Barnes, S., Lanham-New, S. A., & Lambert, H. (2022) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2022.101758 · Cited by 72 · see citing works
Cigarette smoking and risk of hip fracture in women: A meta-analysis of prospective cohort studies
Shen, G., Li, Y., Zhao, G., Zhou, H. B., Xie, Z. G., Xu, W., Chen, H. N., Dong, Q. R., & Xu, Y. J. (2015) · Injury · doi:10.1016/j.injury.2015.04.008 · Cited by 73 · see citing works
“Some researches demonstrated a positive association between cigarette smoking and hip fracture [5,13,16,17,19–21,23], whereas others failed to show such a relationship [14,18,22].”
BackgroundResult
The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health
Winther, A., Dennison, E. M., Ahmed, L. A., Furberg, A., Grimnes, G., Jorde, R., Gjesdal, C. G., & Emaus, N. (2014) · Archives of Osteoporosis · doi:10.1007/s11657-014-0185-0 · Cited by 70 · see citing works
“The effect of smoking is also influenced by dose and duration [42], which can explain diverging study results.”
Result
A review of lifestyle, smoking and other modifiable risk factors for osteoporotic fractures.
Abrahamsen, B., Brask-Lindemann, D., Rubin, K., & Schwarz, P. (2014) · BoneKEy Reports · doi:10.1038/bonekey.2014.69 · Cited by 74 · see citing works
“Indirect effects on bone cells Smoking has been shown to induce alterations in the calciotropic and adrenal cortical hormone metabolism, leading to further increased bone resorption.(26) In clinical studies, smoking has been associated with increased cortisol levels.”
Background
An Overlooked Bone Metabolic Disorder: Cigarette Smoking-Induced Osteoporosis
Weng, W., Li, H., & Zhu, S. (2022) · Genes · doi:10.3390/genes13050806 · Cited by 65 · see citing works
“Several studies have shown the RANKL-RANK-OPG pathway is also involved in indirect pathophysiological mechanisms (PTH-vitamin D axis and gonadal hormones), which makes this pathway of great therapeutic interest [90].”
BackgroundInfluential
Factors associated with bisphosphonate treatment failure in postmenopausal women with primary osteoporosis
Cairoli, E., Eller-Vainicher, C., Ulivieri, F. M., Zhukouskaya, V. V., Palmieri, S., Morelli, V., Beck‐Peccoz, P., & Chiodini, I. (2014) · Osteoporosis International · doi:10.1007/s00198-014-2619-3 · Cited by 65 · see citing works
“This finding is in keeping with the concept that current smoking is a known and widely demonstrated risk factor for fragility fracture independent of BMD [30–34], insomuch as it is included in the FRAX® algorithms.”
Result
The Impact of Smoking on Bone Metabolism, Bone Mineral Density and Vertebral Fractures in Postmenopausal Women
Trevisan, C., Alessi, A., Girotti, G., Zanforlini, B. M., Bertocco, A. G., Mazzochin, M., Zoccarato, F., Piovesan, F., Dianin, M., Giannini, S., et al. (2019) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2019.07.007 · Cited by 64 · see citing works
“Smoking can have negative effects on bone health through a double mechanism[11].”
Background
Impact of smoking on estrogenic efficacy
Ruan, X., & Mueck, A. O. (2015) · Climacteric · doi:10.3109/13697137.2014.929106 · Cited by 61 · see citing works
Cigarette Smoke Induces the Risk of Metabolic Bone Diseases: Transforming Growth Factor Beta Signaling Impairment via Dysfunctional Primary Cilia Affects Migration, Proliferation, and Differentiation of Human Mesenchymal Stem Cells
Aspera-Werz, R. H., Chen, T., Ehnert, S., Zhu, S., Fröhlich, T., & Nussler, A. K. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20122915 · Cited by 58 · see citing works
A Mini Review on Osteoporosis: From Biology to Pharmacological Management of Bone Loss
Chin, K., Ng, B. N., Rostam, M. K. I., Fadzil, N. F. D. M., Raman, V., Yunus, F. M., Hashim, S. A. S., & Ekeuku, S. O. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11216434 · Cited by 61 · see citing works
“Apart from direct toxic effects on bone cells, chemicals in tobacco can cause alterations in calciotropic hormone levels and intestinal calcium absorption, dysregulation in sex hormone production and metabolism, adrenal cortical hormone levels and the RANK/RANKL/OPG system [42,123].”
Background
Association of geriatric nutritional risk index with the risk of osteoporosis in the elderly population in the NHANES
Huang, W., Xiao, Y., Wang, H., & Li, K. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.965487 · Cited by 61 · see citing works
“Smoking has an effect on bone integrity, where this adverse effect is mainly attributed to nicotine, one of the main components of the particulate phase of tobacco smoke (18).”
Background
The Effects of Cigarette Smoke Condensate and Nicotine on Periodontal Tissue in a Periodontitis Model Mouse
Kubota, M., Yanagita, M., Mori, K., Hasegawa, S., Yamashita, M., Yamada, S., Kitamura, M., & Murakami, S. (2016) · PLoS ONE · doi:10.1371/journal.pone.0155594 · Cited by 59 · see citing works
“Cigarette smoking is associated with reduced bone mineral density (BMD) [25]; therefore, the BMD of alveolar bone may be a useful parameter for evaluating the effect of cigarette smoking in periodontal diseases.”
Background
Effects of Antipsychotics on Bone Mineral Density in Patients with Schizophrenia: Gender Differences
Chen, C., Lane, H., & Lin, C. (2016) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2016.14.3.238 · Cited by 56 · see citing works
Impact of occupational cadmium exposure on bone in sewage workers
Taha, M. M., Mahdy-Abdallah, H., Shahy, E. M., Ibrahim, K. S., & Elserougy, S. (2018) · International Journal of Occupational and Environmental Health · doi:10.1080/10773525.2018.1518745 · Cited by 53 · see citing works
“It can be suggested that common allelic variants of ER-α gene led to different responsiveness to estrogen in different population [45].”
Background
Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic
Tarantino, U., Cariati, I., Greggi, C., Gasbarra, E., Belluati, A., Ciolli, L., Maccauro, G., Momoli, A., Ripanti, S., Falez, F., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22126629 · Cited by 52 · see citing works
“Cigarette smoking is also considered one of the main social risk factors for developing metabolic bone diseases (such as osteoporosis, Paget’s disease, osteomalacia, and diabetic osteopathy), which compromise bone remodeling for a variety of reasons, including altered bone formation by osteoblasts, increased bone degr…”
Background
Osteoporosis in thalassemia major: an update and the I-CET 2013 recommendations for surveillance and treatment.
Sanctis, V. D., Soliman, A. T., Elsedfy, H. H., Yassin, M. A., Canatan, D., Kılınç, Y., Sobti, P. C., Skordis, N., Karimi, M., Raiola, G., et al. (2013) · PubMed · Cited by 52 · see citing works
Pathophysiology of tobacco smoke exposure: Recent insights from comparative and redox proteomics
Colombo, G., Clerici, M., Giustarini, D., Portinaro, N. M., Aldini, G., Rossi, R., Milzani, A., & Dalle‐Donne, I. (2013) · Mass Spectrometry Reviews · doi:10.1002/mas.21392 · Cited by 52 · see citing works
Pathogenesis of (smoking-related) non-communicable diseases—Evidence for a common underlying pathophysiological pattern
Kopp, W. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.1037750 · Cited by 55 · see citing works
Osteoporosis in chronic obstructive pulmonary disease
Romme, E. A., Smeenk, F. W. J. M., Rutten, E. P. A., & Wouters, E. F. �. (2013) · Expert Review of Respiratory Medicine · doi:10.1586/17476348.2013.814402 · Cited by 49 · see citing works
Musculoskeletal crosstalk in chronic obstructive pulmonary disease and comorbidities: Emerging roles and therapeutic potentials.
Mou, K., Chan, S. M. H., & Vlahos, R. (2024) · Pharmacology and Therapeutics · doi:10.1016/j.pharmthera.2024.108635 · Cited by 51 · see citing works
Cinnamon-flavored electronic cigarette liquids and aerosols induce oxidative stress in human osteoblast-like MG-63 cells
Wavreil, F. D. M., & Heggland, S. J. (2019) · Toxicology Reports · doi:10.1016/j.toxrep.2019.11.019 · Cited by 47 · see citing works
“Tobacco smoke also induces an increase in production of parathyroid hormone and cortisol or a reduction in vitamin D metabolism, indirectly affecting the bone remodeling process [24,28].”
Background
Early Initiation of Smoking and Alcohol Drinking as a Predictor of Lower Forearm Bone Mineral Density in Late Adolescence: A Cohort Study in Girls
Lucas, R., Fraga, S., Ramos, E., & Barros, H. (2012) · PLoS ONE · doi:10.1371/journal.pone.0046940 · Cited by 45 · see citing works
“Smoking may also act on bone metabolism by promoting accelerated estrogen metabolism and elimination, decreasing serum levels of calciotropic hormones, and increasing the secretion of adrenocortical hormones [28].”
Background
Effect of Smoking Status on Successful Arthrodesis, Clinical Outcome, and Complications After Anterior Lumbar Interbody Fusion (ALIF)
Phan, K. H., Fadhil, M., Chang, N. B., Giang, G., Gragnaniello, C., & Mobbs, R. J. (2017) · World Neurosurgery · doi:10.1016/j.wneu.2017.11.157 · Cited by 46 · see citing works
The association between body mass index and osteoporosis in a Taiwanese population: a cross-sectional and longitudinal study
Chiu, C.-T., Lee, J., Lu, C., Huang, S., Chen, S., & Geng, J. (2024) · Scientific Reports · doi:10.1038/s41598-024-59159-4 · Cited by 45 · see citing works
Life Satisfaction and Bone Mineral Density Among Postmenopausal Women
Rauma, P. H., Koivumaa-Honkanen, H. T., Williams, L. J., Tuppurainen, M. T., Kröger, H., & Honkanen, R. (2014) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000114 · Cited by 44 · see citing works
“For example, smoking (52) and heavy alcohol use (53) have been shown to decrease BMD, whereas moderate alcohol use seems to be associated with increased BMD in postmenopausal women (54,55), which was also seen in this study.”
Background
Vitamin D deficiency in patients with intellectual disabilities: prevalence, risk factors and management strategies
Frighi, V., Morovat, A., Stephenson, M. T., White, S. J., Hammond, C. V., & Goodwin, G. M. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.113.143511 · Cited by 44 · see citing works
Prevalence and Fracture Risk of Osteoporosis in Patients with Rheumatoid Arthritis: A Multicenter Comparative Study of the FRAX and WHO Criteria
Choi, S. T., Kwon, S., Jung, J.-Y., Kim, H., Kim, S.-S., Kim, S.-H., Kim, J., Park, J. H., & Suh, C. (2018) · Journal of Clinical Medicine · doi:10.3390/jcm7120507 · Cited by 44 · see citing works
“Although smoking has been known to be a major risk factor in many studies [11,22], it was not a statistically significance factor in our study, which was probably due to the fact that the majority of patients enrolled in our study were postmenopausal women with a smoking rate of only 6.”
Bisphosphonates Reduce Smoking-Induced Osteoporotic-Like Alterations by Regulating RANKL/OPG in an Osteoblast and Osteoclast Co-Culture Model
Zhu, S., Häussling, V., Aspera-Werz, R. H., Chen, T., Braun, B., Weng, W., Histing, T., & Nussler, A. K. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms22010053 · Cited by 42 · see citing works
“The alterations may occur as direct or indirect effects of CS constituents on osteoblastic bone formation, and/or osteoclastic bone resorption, resulting in an imbalance between osteoblasts and osteoclasts [12].”
Background
Dietary Fiber, Genetic Variations of Gut Microbiota-derived Short-chain Fatty Acids, and Bone Health in UK Biobank
Zhou, T., Wang, M., Ma, H., Li, X., Heianza, Y., & Qi, L. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa740 · Cited by 42 · see citing works
Fracture Risk and Risk Factors for Osteoporosis
Schürer, C., Wallaschofski, H., Nauck, M. A., Völzke, H., Schober, H., & Hannemann, A. (2015) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2015.0365 · Cited by 40 · see citing works
Association between vitamin D deficiency and periodontal status in current smokers
Lee, H., Je, D., Won, S., Paik, D., & Bae, K. (2015) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12173 · Cited by 40 · see citing works
“In addition, smoking may be associated with an increased risk of vitamin D deficiency as it may alter the hepatic metabolism of vitamin D by influencing 25 hydroxylase (33, 34).”
Background
Considerations in the Treatment of Osteoporotic Distal Radius Fractures in Elderly Patients
Ostergaard, P. J., Hall, M. J., & Rozental, T. D. (2019) · Current Reviews in Musculoskeletal Medicine · doi:10.1007/s12178-019-09531-z · Cited by 39 · see citing works
The Long-Term Effect of Smoking on 10 Years’ Survival and Success of Dental Implants: A Prospective Analysis of 453 Implants in a Non-University Setting
Windael, S., Vervaeke, S., Buyser, S. L. D., Bruyn, H. D., & Collaert, B. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9041056 · Cited by 43 · see citing works
“Cigarette smoking is associated with a reduction in bone mineral density in a dose-related and duration-related manner [7,30].”
Background
Tocotrienols for bone health: a translational approach
Shen, C., Klein, A., Chin, K., Mo, H., Tsai, P., Yang, R., Chyu, M., & Ima‐Nirwana, S. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13449 · Cited by 38 · see citing works
Osteoporosis in patients with intestinal insufficiency and intestinal failure: Prevalence and clinical risk factors.
Nygaard, L., Skallerup, A., Olesen, S. S., Køhler, M., Vinter-jensen, L., Kruse, C., Vestergaard, P., & Rasmussen, H. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2017.07.018 · Cited by 27 · see citing works
Injury Occurrence and Return to Dance in Professional Ballet: Prospective Analysis of Specific Correlates
Novosel, B., Sekulić, D., Perić, M., Kondrič, M., & Zaletel, P. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16050765 · Cited by 35 · see citing works
“Additionally, some systematic effects of cigarette smoking, such as chronic inflammation, vascular damage, and increased oxidative stress, may negatively affect bone mineral content [29,30].”
Background
Depression and Disturbed Bone Metabolism: A Narrative Review of the Epidemiological Findings and Postulated Mechanisms
Rosenblat, J. D., Gregory, J. M., Carvalho, A. F., & McIntyre, R. S. (2016) · Current Molecular Medicine · doi:10.2174/1566524016666160126144303 · Cited by 34 · see citing works
The Impact of Obesity and Smoking on Outcomes After Volar Plate Fixation of Distal Radius Fractures
Hall, M. J., Ostergaard, P. J., Dowlatshahi, A. S., Harper, C. M., Earp, B. E., & Rozental, T. D. (2019) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2019.08.017 · Cited by 34 · see citing works
Electronic cigarette liquid exposure induces flavor‐dependent osteotoxicity and increases expression of a key bone marker, collagen type I
Otero, C. E., Noeker, J. A., Brown, M. M., Wavreil, F. D. M., Harvey, W. A., Mitchell, K. A., & Heggland, S. J. (2019) · Journal of Applied Toxicology · doi:10.1002/jat.3777 · Cited by 33 · see citing works
“First, tobacco smoke exposure can indirectly alter bone function by increasing parathyroid hormone release, increasing cortisol production or reducing vitamin D metabolism (Abate, Vanni, Pantalone, & Salini, 2013; Yoon et al., 2012).”
The deleterious effects of smoking in bone mineralization and fibrillar matrix composition
Barbosa, A. P., Lourenço, J. D., Junqueira, J. J. M., de França, S. L. E., Martins, J. D. S., Oliveira‐Junior, M. C., Begalli, I., Velosa, A. P. P., Olivo, C. R., Bastos, T. B., et al. (2019) · Life Sciences · doi:10.1016/j.lfs.2019.117132 · Cited by 33 · see citing works
Bone density loss on computed tomography at 3-year follow-up in current compared to former male smokers
Pompe, E., Bartstra, J. W., Verhaar, H. J. J., de Koning, H. J., van der Aalst, C. M., Oudkerk, M., Vliegenthart, R., Lammers, J. J., de Jong, P. A., & Hoesein, F. A. A. M. (2017) · European Journal of Radiology · doi:10.1016/j.ejrad.2017.02.011 · Cited by 32 · see citing works
Impact of Cigarette Smoking on the Risk of Osteoporosis in Inflammatory Bowel Diseases
Ratajczak, A. E., Szymczak‐Tomczak, A., Rychter, A. M., Zawada, A. E., Dobrowolska, A., & Krela‐Kaźmierczak, I. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10071515 · Cited by 35 · see citing works
“Additionally, nicotine disturbs the hydroxylation of vitamin D, affecting OPG and RANK [30].”
Background
Effects of long-term cigarette smoke exposure on bone metabolism, structure, and quality in a mouse model of emphysema
Sasaki, M., Chubachi, S., Kameyama, N., Sato, M., Haraguchi, M., Miyazaki, M., Takahashi, S., Nakano, T., Kuroda, Y., Betsuyaku, T., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0191611 · Cited by 31 · see citing works
E-vapor aerosols do not compromise bone integrity relative to cigarette smoke after 6-month inhalation in an ApoE–/– mouse model
Reumann, M. K., Schaefer, J. P., Titz, B., Aspera-Werz, R. H., Wong, E. T., Szostak, J., Häussling, V., Ehnert, S., Leroy, P., Tan, W. T., et al. (2020) · Archives of Toxicology · doi:10.1007/s00204-020-02769-4 · Cited by 30 · see citing works
Bone Fragility in Gastrointestinal Disorders
Merlotti, D., Mingiano, C., Valenti, R., Cavati, G., Calabrese, M., Pirrotta, F., Bianciardi, S., Palazzuoli, A., & Gennari, L. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23052713 · Cited by 29 · see citing works
“Additionally, smokers have a lower OPG level and higher RANKL/OPG ratio when compared with non-smokers [32], while nicotine disturbs the hydroxylation of vitamin D [33].”
Background
Targeted inhibition of ferroptosis in bone marrow mesenchymal stem cells by engineered exosomes alleviates bone loss in smoking-related osteoporosis
Wang, Y., Sun, L., Dong, Z., Zhang, T., Wang, L., Cao, Y., Xu, H., Liu, C., & Chen, B. (2025) · Materials Today Bio · doi:10.1016/j.mtbio.2025.101501 · Cited by 27 · see citing works
“Additionally, once tobacco-derived toxins reach the skeletal system via the bloodstream, they trigger inflammation, impair bone nutrition, and disrupt bone metabolism [5 – 7].”
A close relationship between HIF-1α expression and bone metastases in advanced NSCLC, a retrospective analysis
Pezzuto, A., Perrone, G., Orlando, N., Citarella, F., Ciccozzi, M., Scarlata, S., & Tonini, G. (2019) · Oncotarget · doi:10.18632/oncotarget.27378 · Cited by 27 · see citing works
“It also favors bone metastases through the activation of several growth factors, transcriptional factors, oncogene activation and inhibition of apoptosis [10, 11].”
Background
Interleukin-17A Deficiency Attenuated Emphysema and Bone Loss in Mice Exposed to Cigarette Smoke
Xiong, J., Tian, J., Zhou, L., Le, Y., & Sun, Y. (2020) · International Journal of COPD · doi:10.2147/copd.s235384 · Cited by 26 · see citing works
Idiopathic Osteoporosis and Nephrolithiasis: Two Sides of the Same Coin?
Rendina, D., FILIPPO, G. D., Iannuzzo, G., Abate, V., Strazzullo, P., & Falchetti, A. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21218183 · Cited by 26 · see citing works
“Nicotine also has an inhibitory effect on osteogenesis [105,106].”
Background
Determinants of Secondary Hyperparathyroidism in Bariatric Patients after Roux-en-Y Gastric Bypass or Sleeve Gastrectomy: A Pilot Study
Alexandrou, A. P., Tsoka, E., Armeni, E., Rizos, D., Diamantis, T., Augoulea, A., Panoulis, C., Liakakos, T., & Lambrinoudaki, I. V. (2015) · International Journal of Endocrinology · doi:10.1155/2015/984935 · Cited by 26 · see citing works
“Representing a known risk factor of bone loss, smoking may interact with 25 hydroxylase in the liver, resulting in lower levels of 25(OH) vitamin D [28].”
Background
Smoking and other determinants of bone turnover
Jorde, R., Stunes, A. K., Kubiak, J., Grimnes, G., Thorsby, P. M., & Syversen, U. (2019) · PLOS ONE · doi:10.1371/journal.pone.0225539 · Cited by 25 · see citing works
“Smokers also had significantly lower creatinine than non-smokers, a difference that also was significant (P 0.001) after adjusting for sex, age and BMI.”
BackgroundInfluential
Fractal dimension and lacunarity analysis of mandibular bone on digital panoramic radiographs of tobacco users
Suman, B., Vijayalakshmi, K. R., & Kumar, S. (2021) · Journal of Dental Research Dental Clinics Dental Prospects · doi:10.34172/joddd.2021.024 · Cited by 25 · see citing works
Adherence to Lifestyle Recommendations for Bone Health in Older Adults with and without Osteoporosis: Cross-Sectional Results of the OUTDOOR ACTIVE Study
Albrecht, B. M., Stalling, I., Foettinger, L., Recke, C., & Bammann, K. (2022) · Nutrients · doi:10.3390/nu14122463 · Cited by 25 · see citing works
“Smoking has similar effects on the skeletal system and should be ceased [20].”
Background
Impact of Chronic Inflammation in Psoriasis on Bone Metabolism
Saalbach, A., & Kunz, M. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.925503 · Cited by 25 · see citing works
Associations between exercise, bone mineral density, and body composition in adolescents with anorexia nervosa
Nagata, J. M., Carlson, J. L., Golden, N. H., Murray, S. B., Long, J., Leonard, M. B., & Peebles, R. (2018) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-018-0521-2 · Cited by 25 · see citing works
“The semi-structured interview also included questions about menstrual status, self-reported tobacco use in the past month [23] and current use of antidepressants such as serotonin selective receptor uptake inhibitors (SSRI) [24] or tricyclic antidepressants (TCA) [25].”
Early-life tobacco smoke elevating later-life osteoporosis risk: Mediated by telomere length and interplayed with genetic predisposition
Di, D., Zhou, H., Cui, Z., Zhang, J., Liu, Q., Yuan, T., Zhou, T., Luo, X., Ling, D., & Wang, Q. (2024) · Journal of Advanced Research · doi:10.1016/j.jare.2024.02.021 · Cited by 24 · see citing works
Cigarette smoking and hip volumetric bone mineral density and cortical volume loss in older adults: The AGES-Reykjavik study
Marques, E. A., Elbejjani, M., Gudnason, V. G., Sigurdsson, G. T., Lang, T., Sigurdsson, S. O., Aspelund, T., Siggeirsdóttir, K., Launer, L. J., Eiríksdóttir, G., et al. (2018) · Bone · doi:10.1016/j.bone.2018.01.014 · Cited by 23 · see citing works
“(11) Several potential mechanisms have been proposed to explain the relationship between smoking and poorer bone health; these include mechanisms that represent more direct effects of smoking on bone cells, and other mechanisms influenced by factors such as body weight, physical activity, calcitropic processes, and se…”
Background
Bone health and body composition in transgender adults before gender-affirming hormonal therapy: data from the COMET study
Ceolin, C., Scala, A., Dall’Agnol, M., Ziliotto, C., Delbarba, A., Facondo, P., Citron, A., Vescovi, B., Pasqualini, S., Giannini, S., et al. (2023) · Journal of Endocrinological Investigation · doi:10.1007/s40618-023-02156-7 · Cited by 23 · see citing works
“Gender dysphoria (GD) is defined as a condition of psychological distress associated with gender incongruence [3].”
BackgroundResultInfluential
Cigarette Smoke Exposure Inhibits Osteoclast Apoptosis via the mtROS Pathway
Qin, Y., Liu, Y., Jiang, Y., Mei, S., Liu, Y., Feng, J., Guo, L., Du, J., Graves, D. T., & Liu, Y. (2021) · Journal of Dental Research · doi:10.1177/00220345211009471 · Cited by 22 · see citing works
“Alterations in bone remodeling occur when nicotine or other constituents of cigarette smoke have indirect or direct effects on osteoblastic bone formation and osteoclast-mediated bone resorption (Ren et al. 2005; Yoon et al. 2012).”
Background
Vitamin D Status of Residents in Taiyuan, China and Influencing Factors
Yan, X., Thomson, J. S., Zhao, R., Zhu, R., Wang, Z., Zhang, N., & Coad, J. (2017) · Nutrients · doi:10.3390/nu9080898 · Cited by 22 · see citing works
“Other studies have also found smoking to have a significant negative association with serum 25(OH)D [21,44].”
Background
Adverse Effects of Smoking on Peak Bone Mass May Be Attenuated by Higher Body Mass Index in Young Female Smokers
Callréus, M., McGuigan, F. E., & Åkesson, K. (2013) · Calcified Tissue International · doi:10.1007/s00223-013-9785-8 · Cited by 21 · see citing works
“Meta-analyses have suggested that smoking-induced bone loss may be partially reversed by cessation of smoking [2, 31].”
Bone health in haemophilia carriers and persons with von Willebrand disease: A large database analysis
Sridhar, D. C., Sidonio, R. F., & Ahuja, S. P. (2022) · Haemophilia · doi:10.1111/hae.14565 · Cited by 21 · see citing works
Bone health in patients with inflammatory bowel disease
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Smoking & Bone
Watanabe, R., & inoue, D. (n.d.) · Institutional Repositories DataBase (IRDB)

Authors: Yoon, V., Maalouf, N. M., & Sakhaee, K.
Affiliations: The University of Texas Southwestern Medical Center (US)
Corresponding author: Sakhaee, K.
ORCID: Maalouf, N. M.
Sakhaee, K.
Venue: Osteoporosis International
Publisher: Springer Science and Business Media LLC
Published: 2012-02-21
Volume: 23
Issue: 8
Pages: 2081-2092
ISSN: 0937-941X (ISSN-L)
1433-2965
DOI: 10.1007/s00198-012-1940-y
OpenAlex: W2142262092
Cited by: 268
References: 134
Citations by year: 2026: 14 · 2025: 25 · 2024: 20 · 2023: 25 · 2022: 26 · 2021: 18 · 2020: 21 · 2019: 23 · 2018: 15 · 2017: 13 · 2016: 13 · 2015: 14 · 2014: 18 · 2013: 16 · 2012: 7
FWCI: 3.12
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Osteoporosis International (publishedVersion)
PubMed (publishedVersion)
Funders: Amgen
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords: cigarette smoking, osteoporosis, bone metabolism, bone mineral density, fracture risk, sex hormones, RANK/RANKL/OPG system, calcium absorption, smoking cessation, bone loss
MeSH terms: Adrenal Cortex Hormones, Adult, Aged, Aged, 80 and over, Animals, Bone and Bones, Calcitriol, Female, Humans, Male, Middle Aged, Osteoblasts, Osteoclasts, Osteoporosis, Parathyroid Hormone, Gonadal Steroid Hormones, Smoking, Bone Density, Smoking Cessation, Intercellular Signaling Peptides and Proteins, Young Adult, Osteoporotic Fractures

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The effects of smoking on bone metabolism

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