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Effects of smoking habit change on hospitalized fractures: a retrospective cohort study in a male population

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Abstract

Summary

We examined effects of smoking habit change on fracture risk in men. Long-term quitters and never smokers showed decreased risk for overall fractures, lumbar fractures, and other site fractures. Short-term quitters did not show decreased risk. Longer time since smoking cessation may lead to decreased fracture risk in men.

Purpose

Cigarette smoking is a well-known modifiable risk factor of osteoporosis and fractures. This study investigated the effects of change in smoking habits on risks of all types of fractures in men using a nationwide health claims database.

Methods

Retrospective study was performed using the Korean National Health Insurance Service-National Sample Cohort Data. Cox proportional hazards regression analyses were performed to estimate risks of all types of hospitalized fractures, hip fractures, lumbar fractures, and other site fractures (all other fractures excluding the lumbar and hip areas).

Results

Compared to continued smokers, long-term quitters and never smokers showed decreased risk for all types of fractures (adjusted hazard ratio (aHR) 0.83, 95% confidence interval (CI) 0.78–0.88 and aHR 0.84, 95% CI 0.80–0.89, respectively). According to skeletal site, long-term quitters and never smokers showed decreased risk for lumbar fractures (aHR 0.82, 95% CI 0.68–0.98 and aHR 0.85, 95% CI 0.73–0.99, respectively) and other site fractures (aHR 0.83, 95% CI 0.78–0.89 and aHR 0.85, 95% CI 0.81–0.90, respectively). Hip fractures were decreased in never smokers (aHR 0.77, 95% CI 0.62–0.94). Short-term quitters did not show decreased risk for fractures.

Conclusions

Longer time since smoking cessation in men may lead to decreased risk for fractures, especially lumbar and other site fractures. Physicians should counsel patients at risk for fractures both to quit smoking and to maintain abstinence from smoking. Further studies may be required to help comprehend how smoking cessation can affect fracture risk.

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Author notes

  1. In Young Cho and Mi Hee Cho contributed equally as first authors.

Authors and Affiliations

  1. Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea

    In Young Cho

  2. Samsung S&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 05288, Republic of Korea

    Mi Hee Cho

  3. Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea

    Kiheon Lee, Hyejin Lee & Hye-Yeon Koo

  4. Department of Family Medicine, College of Medicine, Seoul National University, Seoul, 03080, Republic of Korea

    Kiheon Lee & Sang Min Park

  5. Department of Family Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea

    Sang Min Park, Joung Sik Son & Ye Seul Bae

  6. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03080, Republic of Korea

    Kyuwoong Kim, Seulggie Choi, Jooyoung Chang & Sung Min Kim

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  1. In Young Cho
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Correspondence to Kiheon Lee.

Ethics declarations

This study was approved by the Institutional Review Board at Seoul National University Bundang Hospital (IRB No. X-1809-493-902), which waived informed consents from study participants due to anonymity of the data from the NHIS database. The study was conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cho, I.Y., Cho, M.H., Lee, K. et al. Effects of smoking habit change on hospitalized fractures: a retrospective cohort study in a male population. Arch Osteoporos 15, 29 (2020). https://doi.org/10.1007/s11657-020-0686-y

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