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How smoking harms your bones

Illustration of a man with hand on lower back, in pain.

Dec. 8, 2022—Sure, you know smoking can wreak havoc on your lungs—not to mention your heart and a whole lot more of your body. But what about your bones in particular? Can smoking hurt them too? Absolutely. Although you might not realize it, smoking may weaken your sturdy skeleton and raise your risk for painful problems.

According to the American Academy of Orthopaedic Surgeons, some of the musculoskeletal health problems linked to smoking include:

  • Osteoporosis and broken bones. Smoking raises your risk of osteoporosis, a bone-weakening disease that can cause bones to fracture easily. Among smokers, broken bones take longer to heal. Smoking is just one risk factor for osteoporosis.
  • Tendon injuries. Compared to non-smokers, smokers tend to have more tendon tears and larger rotator cuff (shoulder) injuries.
  • Spine problems. Smoking has been linked to an increased risk of low-back pain.

How can smoking harm your musculoskeletal system?

Researchers are still learning about the different ways smoking may harm bones, vertebrae and other tissues. But among other possible avenues, it appears smoking may weaken bones by reducing their blood supply, slowing their ability to form new bone cells needed to rebuild themselves and by interfering with the body's ability to absorb the mineral calcium.

Smoking also may indirectly damage bones. For instance, compared to non-smokers, many smokers have a thin body frame, which is a risk factor for fragile bones, the National Institute of Arthritis and Musculoskeletal and Skin Diseases reports. This could be because nicotine suppresses the appetite. In addition, many women who smoke reach menopause earlier than those who don't smoke. During menopause, estrogen levels drop. Estrogen is a hormone that helps protect bones.

It's never too late to quit

If you smoke, quitting can help protect your bones and your overall health. Talk to your doctor about medicines and stop-smoking programs that may help you quit. For more information on quitting smoking and how you may benefit, check out our Smoking health topic center.


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