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Fracture risk associated with smoking: a meta-analysis
1Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark. p-vest@post4.tele.dk
Journal of Internal Medicine
|December 4, 2003
Summary
Smoking significantly increases fracture risk, particularly for hip and spine fractures. Quitting smoking appears to reduce this risk, though geographical variations exist, with higher risks at increased latitudes.
Area of Science:
- Epidemiology
- Public Health
- Orthopedics
Background:
- Smoking is a prevalent behavior with numerous adverse health effects.
- Understanding the specific risks associated with smoking, such as fracture development, is crucial for public health initiatives.
Purpose of the Study:
- To systematically review and synthesize evidence on the association between smoking and fracture risk.
- To quantify the risk of different fracture types in current and former smokers.
Main Methods:
- A systematic review of cohort, case-control, and cross-sectional studies.
- Searches were conducted in PubMed and EMBASE, supplemented by reference list screening.
- Fifty studies involving over 512,000 participants were included.
Main Results:
- Current smoking was associated with a significantly increased risk of overall fractures (RR 1.26), hip fractures (RR 1.39), and spine fractures (RR 1.76).
- No significant association was found for wrist fractures.
- Previous smokers showed a reduced, but still elevated, risk for all fracture types and hip fractures compared to current smokers.
Conclusions:
- Smoking is a significant risk factor for overall, hip, and spine fractures, but not wrist fractures.
- Smoking cessation may mitigate fracture risk.
- Geographical variations in fracture risk associated with smoking were observed, increasing with latitude.