Volume 177 - Issue 3
Preventing osteoporosis: outcomes of the Australian Fracture Prevention Summit
Authors: Roy PL Carey, Walter E Plehwe and Peter R Ebeling
Med J Aust 2002; 177 (3): 167. || doi: 10.5694/j.1326-5377.2002.tb04717.x
Published online: 5 August 2002
Published online: 5 August 2002
To the Editor: We were interested to read the recent supplement on preventing osteoporosis.1 We could find only one reference to cigarette smoking, on page S13, where it is noted that "the role of lifestyle changes (including specific exercise regimens, changes in diet and quitting smoking) has not been evaluated adequately".
The orthopaedic literature is replete with information and evidence on the adverse effects of cigarette smoking on bone density, healing of fractures, incorporation of bone grafts, etc. A meta-analysis2 has suggested that smokers have greater bone loss over time than non-smokers.
Granted, there may as yet be no direct evidence that quitting smoking reduces "the fracture burden". However, to discuss osteoporosis and management of fractures without discussing the major adverse effects of cigarette smoking is akin to discussing the prevention of melanoma and the outcomes of treatment without discussing unprotected exposure to sunlight (for example).
Could the "writing group" tell us what steps are being taken to inform Australians of the adverse effects of cigarette smoking on their bones, quite apart from the other public health issues surrounding this extraordinarily harmful habit?
References
- Sambrook PN, Seeman E, Phillips SR, Ebeling PR. Preventing osteoporosis: outcomes of the Australian Fracture Prevention Summit. Med J Aust 2002; 176 Suppl Apr 15: S1-S16. <eMJA full text>
- Ward KI, Klesges RC. A meta-analysis of the effects of cigarette smoking on bone mineral density. Calcif Tissue Int 2001; 68: 259-270.
- Ward KS, Klesges RC. A meta-analysis of the effects of cigarette smoking and bone mineral density. Calcif Tissue Int 2001; 68: 259-270. a1
- Legrand ER, Chappard D, Insalaco P, et al. Trabecular bone microarchitecture is related to clinical risk factors in osteoporosis in men. Bone 2002; 13(Suppl 1): S5. a2
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