The Effects Of Smoking On Musculoskeletal Health

It’s common knowledge that smoking is bad for health. In the UK, according to the NHS, 114,000 people die each year of smoking related illnesses. In the US, the figure is 443,000 and as reported by Centers for Disease Control and Prevention, smoking is the cause of one out of every five deaths. Smoking damages the lungs and causes conditions such as bronchitis, emphysema, pneumonia and 90% of lung cancers…in addition to several other types of cancer. It also damages the heart and circulatory system and increases the risk of getting coronary heart disease, heart attacks and strokes…but we know all that, what we’re less familiar with are the effects on the musculoskeletal system.

Lets take a closer look at some of the harmful constituents of cigarette smoke: nicotine, carbon monoxide and hydrogen cyanide. Nicotine causes a narrowing of blood vessels and thus decreases blood flow to tissues. Nicotine also increases the risk of blood clots by increasing platelet stickiness. Carbon monoxide and hydrogen cyanide both hinder oxygen metabolism and transport. In summary, smoking decreases the blood flow and transport of oxygen to tissues. The supply of nutrients, minerals and oxygen via blood flow is vital for the development and regeneration of cells.

Some of the numerous documented musculoskeletal risk factors associated with tobacco use are:

• poor wound healing and increased rates of postoperative complications such as infections, haematoma, tissue death and skin graft loss
• delayed or deficient ligament healing (in mice)
• shoulder rotator cuff disease
• the development of osteoporosis and osteoporosis related hip fractures
• an extensive body of evidence shows that smoking delays mineralization during the bone healing process, decreases the strength of regenerating bones and increases the incidence of non-union (failure to heal). In one study on wrist fractures, non-smokers took 4.1 months to heal whereas smokers took 7.1 months…almost twice as long! Smokers have been estimated as having 2.5 times more risk of ensuing complications.
• an increase in the incidence of rheumatoid arthritis
• a greater likelihood of developing systemic lupus erythematosus (an inflammatory autoimmune disease affecting connective tissue)

In order to enhance soft tissue healing and fracture healing, as well as for general musculoskeletal health, it’s definitely advisable to stop smoking!