TOPLINE:

Cessation of cigarette smoking might reverse the increased risk for fractures that is observed with the behavior, according to findings from a retrospective study. 

METHODOLOGY:

• Researchers conducted a retrospective analysis of 5992 men (average age, 74 years) in the prospective, population-based Osteoporotic Fractures in Men Study.
• They used self-reported data on current or past smoking habit, as well as cumulative exposure and time since smoking cessation, to determine the cumulative and reversible effects of cigarette smoking on fracture risk and to quantify the proportion of fractures that are preventable by smoking cessation.
• Cox proportional hazard regression analyses were controlled for age, bone mineral density, history of falls and prior fractures, and lifestyle factors.

TAKEAWAY:

• Over a median follow-up of 11.7 years, there was a dose-response relationship between cigarette smoking habit and risk for fractures.
• Current smoking habit was associated with greater risk for fractures (adjusted hazard ratio, 1.85; 95% CI, 1.35-2.54), and, in particular, current smoking habit was associated with nearly threefold higher risk for hip fracture (adjusted hazard ratio, 2.71; 95% CI, 1.47-5.02).
• There was no statistically significant association between past smoking habit and fracture risk, although past smoking habit with the highest tertile of exposure or recent cessation was associated with a 20%-30% higher risk for fractures.
• The researchers estimated that smoking cessation could lead to a 3.9% reduction in fracture risk, and 26.7% of fractures would be prevented if individuals never smoked.

IN PRACTICE:

“Individuals who had quit for longer than 10 years or had a much lower levels of cumulative exposure to cigarettes were not associated with an elevated fracture risk at all, indicating that the impact of cigarette smoking on fracture risk is reversible,” said study author and presenter Nick Tran, student at Macquarie University and research assistant at the University of Technology Sydney, both in Sydney, Australia.

SOURCE:

The study was presented at the American Society for Bone and Mineral Research (ASBMR) 2025 Annual Meeting.

LIMITATIONS:

The study was retrospective and relied on self-reported data.

DISCLOSURES:

The authors reported having no disclosures or conflicts of interest.