Cigarette smoking and bone mineral density in older men

Cigarette smoking is cited as having a detrimental effect on bone mineral density (BMD), with associated increased fracture risk. Most of the data are from studies of women, with few studies of men. We examined the relationship between BMD and cigarette-smoking habit in a population-based study of men who were categorized by self-report as 'never smokers', 'current smokers' and 'ex-smokers'. BMD was measured using dual X-ray absorptiometry (DXA). We examined 453 men aged 65-76 years (mean 69.1). Non-smokers ('never' and 'ex' smokers) were heavier than current smokers (p = 0.05). There was no significant relationship between BMD and smoking habit at any site except the trochanter, where current smokers had significantly lower BMD than did non-smokers. However, after adjusting for age and weight there was no longer a significant relationship. BMD did not relate to pack-years of cigarette smoking. Current smokers consumed significantly more alcohol than non-smokers (p = 0.031), but adjusting for alcohol intake did not alter the BMD-smoking relationship. Cigarette smoking appears not to affect BMD in this group of older men.