Smoking, alcohol, and bone health

Abstract

Smoking and alcohol consumption are two lifestyle factors that have important contributions to skeletal health. Deleterious effects of smoking on the skeleton have been recognized for several decades. Smoking adversely affects bone density and increases hip fracture risk in postmenopausal women. In men emerging evidence is suggestive for similar associations but the evidence is not conclusive. Furthermore, the evidence is inadequate to infer a causal relationship between smoking and reduced bone density before menopause in women and in younger men. Previously, the role of alcohol on skeletal health was not as well studied as that of smoking, and results from those studies suggested both beneficial as well as deleterious effects on the skeleton. However, recent studies on the role of alcohol on the skeleton suggest a "J"-shaped curve. Moderate ingestion of alcohol may offer some degree of benefit to the skeleton. Ongoing research further suggests that both ethanol and non-ethanol components of alcohol affect skeletal heath.