Smoking cessation and bone health: observational and intervention studies in twins and a Quitline population

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Osteoporosis is a major health problem that causes bones to break (fracture) easily. Many bones are susceptible, with hip fractures being the worst outcome of osteoporosis. They cause pain, disability, require major health interventions (surgery and rehabilitation), lead to death in about 20% of cases, and the overall care of hip fracture patients is very expensive. Osteoporosis is treated to reduce the risk of fractures. The prevention and treatment of osteoporosis should include avoidance of factors known to bring on or worsen the condition. Smokers are known to have an increased risk of osteoporosis and fractures. However, it is not known how smoking brings on osteoporosis. Importantly, neither is it clear whether quitting smoking leads to improved bone health (and a reduced risk of fractures). These are important questions for the community in general and for smokers with osteoporosis in particular. We will endeavour to answer these questions by studying twins who do and do not smoke and by observing what happens to measures of bone health (bone mineral density and other factors) in people attempting to quit smoking. New information gained from these studies may lead to better ways of avoiding or treating the damage that smoking does to bone. We may also become able to predict the benefit to bone when people quit smoking.