Smoking Habit

Abstract

Smoking is a commonly recognized cause of morbidity and mortality; its relationship to cardiovascular and pulmonary disease is well established [1]. An association of tobacco along with musculoskeletal pain and dysfunction has been reported [2]. Recent experimental studies of the adverse consequences of smoking relative to bone and soft-tissue healing showed that cigarette smoking interfered with bone graft and wound healing [3, 4], with infection rates in smokers [5], and with musculoskeletal pain and dysfunction [6]. A recent study observed a dose-dependent and time-dependent relationship between smoking and rotator cuff tears m2. Two substances commonly present in a cigarette, nicotine, and carbon monoxide have different roles, but both of them are harmful. Nicotine is recognized to be a potent vasoconstrictor that decreases the delivery of oxygen to tissues. The role of nicotine has been also recognized as one of the reasons of delayed healing of tendon to bone after rotator cuff repair surgery [7], while carbon monoxide decreases cellular oxygen tension levels necessary for cellular metabolism. Vascular insufficiency to the critical portion of the supraspinatus/infraspinatus tendon has a well-defined contribution to the genesis of rotator cuff tear [8]. With the understanding that tobacco smoking creates a plethora of microvascular diseased tissues, ranging from the skin to the heart, it is not hard to imagine that smoking tobacco also would decrease the vascular supply of an already vascularly challenged tissue [9] such as the critical portion of the rotator cuff insertion.