Chapter 11 Other health problems

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Other health problems: Fractures

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Smoking is a major cause of hip fracture, and the effect of smoking on bone mineral

density increases cumulatively with age. Smoking has no effect on bone density in

women until after the menopause, when smokers lose an additional 0.2% of bone

mass each year, or a difference of 6% at age 80. The cumulative risk of hip fracture to

age 85 in women is 19% in smokers and 12% in nonsmokers; to age 90 it is 37%

and 22%. Among all women, one hip fracture in eight is attributable to smoking. The

study from the Royal London School of Medicine concludes as follows. "Smoking in

women from the time of the menopause onwards increases the risk of hip fracture in

old age by about half. This is an insufficiently recognized major adverse effect of

smoking, and it has substantial implications on health care costs. The lower risk in

former smokers indicates that stopping smoking prevents further excess bone loss,

and stopping at the time of the menopause should avoid the excess risk."

British Medical Journal, October 4, 1997, pp. 841-845

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In a study from Japan, smoking increased the risk for hip fracture by more than two

times for both men and women over age 40.

Tobacco and Health, p. 521

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One in eight hip fractures, particularly common in elderly women, is attributable to

smoking.

Reuters, October 3, 1997

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A speaker at a meeting of the American Academy of Orthopaedic Surgeons reported

that nonsmokers' long bone leg fractures healed 80 percent faster than similar

fractures in smokers. Nicotine impairs circulation, and poor circulation is the apparent

reason for the delayed healing.

San Francisco Examiner, February 26, 1995

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Thursday, July 06, 2000

Page 11 of 32

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