In the 1950s nearly everyone smoked. It was hip and happening – and if you were young, it looked cool. If you were a teenager, the reasoning was that it made you look grown up. And because all teenagers hate looking too young, anything that allows at snatch at adulthood is leapt upon with alacrity – from makeup to high-heel shoes to… smoking.

However, the real effects of that smoking have come to light over the past two or three decades – and among the many health disadvantages of smoking is one that is not discussed enough. And that is the effect of smoking on your bones. And as your bones are the very structure of your body – that is all the life you have.

The years of damage

The young always feel that their bodies are strong and can withstand anything they care to ‘throw’ at them. Not so with smoking and bones. Because the years from childhood until age 30 are the prime time for building bone mass, if you are smoking during this time, this vital bone building period is unquestionably compromised. Not only will you end up with less robust bones, you will also develop stunted growth, a smaller overall skeletal structure.

While you’re thinking you’re hip and happening, the risk of osteoporosis is already growing. If you smoke during your bone-building years, your bone mass will peak at a lower level, which puts you at risk for osteoporosis in later life. If you’re still smoking after the age of 30, this will speed up the loss of bone mass – up to 1.5 to 2 times faster. While the entire skeleton can lose bone mass, your most vulnerable areas are the hip, spine and wrist.

When you move on into the 40s and 50s, the damage continues to escalate. Women in particular are losing estrogen at this time – and this factor compounded by smoking creates greater decline and complications for bone health than for non-smokers.

About dem bones

Let’s look at what bones are supposed to be before we bring in the danger of smoking. Bone is living tissue where new bone is constantly formed whilst old bone is being removed.

  • Collagen forms the framework of the bone and calcium is deposited into this framework. Inside our bones, a constant process of renewal goes on. Cells in the bone called osteoclasts break down old bone. Then, working fast, other cells called osteoblasts make use of the calcium to build up new bone. This constant process keeps our bones healthy and strong.
  • When we are young our bones are dense because they are well packed with calcium. This good bone mass increases until ages 25 to 30. This is when we should reach peak bone mass. After, things slow down – bone can break down faster than it can be replaced, and the bone mass begins to decrease. This is the same for both men and women – except that menopause puts women at greater disadvantage.
  • This thinning process during the slowing down period is called osteoporosis. It’s at this time that a lifetime of smoking begins to play its ugly part, presenting the natural thinning process with an already compromised set of bones, depleted and weakened by smoking and ripe and ready for early fracturing.

What smoking does to the bones

  • Smoking reduces the amount of calcium your bones are able to absorb. In addition, Vitamin D, vital in the process of calcium absorption, is compromised by smoking which interferes in the role it has to play. The result is less calcium, therefore less bone mass. And brittle bones are the result.
  • Smoking lowers estrogen levels in both men and women. Estrogen helps bones to hold calcium and other minerals that make them strong. Both male and female smokers have lower bone mineral density than non-smokers of the same age.
  • Cigarette smoke generates free radicals – molecules that attack body’s natural defenses. The result is a chain-reaction of damage throughout the body — including cells, organs, and hormones involved in keeping bones healthy.
  • Smoking, for women, makes bone loss even worse in the menopausal years. Research also suggests that smoking impedes the hormone calcitonin, which helps build bones.
  • Most notably, both nicotine and free radicals kill the osteoblasts – the vital cells needed for making bones.
  • Smoking also damages blood vessels, reducing the supply of oxygen around the body, making the healing process from any fracture much weaker.
  • White blood cells are also affected by nicotine. Their function is to destroy dead tissue and bacteria. Without this function working properly in any area as it should, the risk of infection is increased.

Passive smoking

And while the non-smokers may be smugly thinking they have avoided all this nastiness to the bones (never mind the rest of the body) think again. Inhaling secondhand smoke on a continual basis such as in an office or the home – has levels of serious risk to health that are only recently beginning to be fully understood. Consider the following:

  • When someone smokes, most of the smoke is not drawn into the smoker’s lungs. Instead, it is released into the air where it can be inhaled by non-smokers. If you are in an enclosed space such as a vehicle, office, restaurant or cinema, the risks are greatly increased.
  • Exposure to secondhand smoke during youth and early adulthood may increase the risk of developing low bone mass.
  • Pre-menopausal women exposed to second-hand smoke had a 2.7-fold increase in the risk of osteoporosis (defined as low bone mineral density at the hip) compared with those without exposure.
  • Tobacco smoke contains some 4,000 chemicals and more than 50 of these have been associated with cancer. The chemicals can stay in the air for up to two and a half hours, even in a well-ventilated room.

What types of chemical are released?

  • Hydrogen cyanide – a highly poisonous gas used in chemical weapons and pest control
  • Benzene – found in petrol
  • Formaldehyde – a preservative used to embalm dead bodies
  • Carbon monoxide – a poisonous gas found in car exhaust.

Well… yuk! Doesn’t sound like any of that would be much good for your bones either!

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only nonprofit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

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