My new idea for cigarette warning labels: Smoking increases fracture rates

While it remains to be seen where we end up with the nine new cigarette packaging warning labels proposed by the US Food and Drug Administration, I have a very strong opinion on making the number of labels an even 10 by adding “Smoking increases fracture rates.”

Honestly, there really is no argument at this point about the harmful effects smoking has on our bones. As far back as 1976 there was a suggestion of an association between smoking and osteoporosis, and study after study since then has added to our knowledge of how smoking has an impact on bone health — such as showing that approximately 19% of hip fractures were attributable to tobacco smoking.

What’s also important to me is that many researchers are now examining the effects smoking has on younger people — where many previous studies focused on elderly people. As one example, a recent Belgian study looked at 649 healthy young men at the age of peak bone mass (ages 25-45 years). The smokers in the group reported more fractures and measured lower in bone density. Another study focused on young Swedish men and found that smoking was associated with decreased bone volume, which researchers speculated could contribute to increased fracture risk.

This research highlights our belief that we need to rethink osteoporosis by recognizing that all bone damage has a cause — even at a very early age and even among men.

Let’s hope it also helps label smoking for what it is — a real bone health risk.



Hoidrup, S., E. Prescott, T.I. Sorensen, et al. 2000. Tobacco smoking and risk of hip fracture in men and women. Int J. Epidemiol Apr; 29(2):253-9.

Taes, Youri. Early smoking is associated with peak bone mass and prevalent fractures in young healthy men. ABMSR, 2009, poster session III

Lorentizon, Mattias. Smoking is associated with impaired trabecular micro-architecture due to reduced trabecular thickness in young Swedish men — the GOOD Study. ABMSR, 2009, poster session III


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