Fractures due to low bone-density (osteoporosis) are a major cause of morbidity and disability in older people and can lead to premature death. Smoking is the single most important preventable cause of disease, disability, and death. Smoking is associated with increased risk for fractures as well as fracture-related mortality in men.1 Smoking may result in fractures by causing a reduction in bone mineral density (BMD) by casing an imbanlance in the bone turnover and increasing the risk for fragility fractures.1,2
Though smoking has been recognized as a contributor to impaired bone health and increased susceptibility for fractures, the extent to which smoking cessation can mitigate or reverse this risk has not been sufficiently explored.3 A study presented at the Annual meeting of the American Society for Bone and Mineral Research (ASBMR), Seattle Convention Center, September 2025, which included older men (n = 5,992; mean age: 74 years) from the Osteoporotic Fractures in Men Study has provided new evidence showing a dose-response relationship between smoking exposure and fracture risk. Current smokers experienced an 85% higher risk of fractures. Smoking cessation led to a 3.9% reduction in fracture risk. This highlights that smoking cessation helps in reversing the fracture risk (see Graphic)3,4
Sources: 1. Xu Y, Bao Y, Wang M, Wu Q. Smoking and fracture risk in men: A meta-analysis of cohort studies, using both frequentist and Bayesian approaches. Sci Rep. 2022;12(1):9270. Doi:10.1038/s41598-022-13356-1; 2. Tarantino U, Cariati I, Greggi C, et al. Skeletal system biology and smoke damage: From basic science to medical clinic. International Journal of Molecular Sciences. 2021; 22(12):6629. https://doi.org/10.3390/ijms22126629; 3. Osteoporotic Fractures in Men Study. Cigarette smoking and reversible fracture risk: cumulative and cessation effects [Internet]. ASBMR Annual Meeting Abstracts; 2025. Available from: https://asbmr.confex.com/asbmr/2025/meetingapp.cgi/Paper/4468; 4. Kling J. Quitting smoking may reduce risk for fractures [Internet]. Medscape; 2025. Available from: https://www.medscape.com/viewarticle/quitting-smoking-may-reduce-risk-fractures-2025a1000oka.