Effects of Tobacco and Alcohol Use on Bone

Abstract

Tobacco is used by many individuals during a large proportion of their lives and appears to be associated with an increased risk of fracture of the axial and appendicular skeleton in women and in men. This risk emerges in advanced age and reduces the skeletal protective effects of obesity and estrogen exposure. The effect is mediated, in part, by a reduction in bone mineral density (BMD), which is probably due primarily to increased bone loss. Decreased bone formation and increased bone resorption are responsible for bone loss. Increased bone resorption associated with smoking is, in part, due to a reduction in the production and an acceleration in the degradation of estrogen. The mechanism ..