title: Smoking, smoking cessation, and fracture risk in elderly women followed for 10 years.
abstract: This study examines the impact of smoking and smoking cessation on fracture risk in 75-year-old women followed for 10 years. Smoking increased fracture risk, especially for vertebral fractures. Smoking cessation decreased the risk for vertebral fractures but not for other fracture types.
  
  
  BACKGROUND
  The purpose of this study was to examine effects of smoking and smoking cessation on fracture risk.
  
  
  METHODS
  This prospective observational population-based study followed 1033 women during 10 years from age 75. Data regarding smoking were collected at age 75. Hazard ratios (HRs) and 95 % confidence intervals for fracture were calculated using competing risks proportional hazards regression.
  
  
  RESULTS
  Both former smokers and current smokers had an increased risk for any fracture (HR 1.30; 1.03-1.66, and HR 1.32; 1.01-1.73, respectively) and any osteoporotic fracture (hip, proximal humerus, distal radius, vertebra) (HR 1.31; 1.01-1.70 and HR 1.49; 1.11-1.98, respectively) compared to non-smokers. Former smokers had an increased risk for proximal humerus fractures (HR 2.23; 1.35-3.70), and current smokers had an increased risk for vertebral fractures (HR 2.30; 1.57-3.38) compared to non-smokers. After adjustment for weight, previous fractures, alcohol habits, bone mineral density (BMD), use of corticoids, vitamin D, bisphosphonates, and previous falls, former smokers had an increased risk for proximal humerus fracture (HR 2.07; 1.19-3.57) and current smokers had an increased risk for osteoporotic (HR 1.47; 1.05-2.05) and vertebral fractures (HR 2.50; 1.58-3.95) compared to non-smokers. Former smokers had a decreased risk for vertebral fractures, but not for other types of fractures, compared to current smokers.
  
  
  CONCLUSIONS
  Smoking increased the risk for fracture among elderly women, especially vertebral fractures. Smoking cessation decreased the risk for vertebral fractures but not for other types of fractures.
authors: Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Department of Orthopedics, K54, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.
authors: M H
authors: MH
authors: Thorin
authors: Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Department of Orthopedics, K54, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.
authors: A
authors: A
authors: Wihlborg
authors: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science Malmö, Lund University, Lund, Sweden.|Department of Orthopedics, Skåne University Hospital, 205 02, Malmö, Sweden.
authors: K
authors: K
authors: Åkesson
authors: Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Department of Orthopedics, K54, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden. paul.gerdhem@karolinska.se.
authors: P
authors: P
authors: Gerdhem
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D013548:Sweden / Q000453:epidemiology
keywords: Elderly; Fracture risk; Smoking; Smoking cessation; Women