How smoking and air pollution contribute to bone health decline

Calcium is important for bone mineralization. Less bone minerals makes the bone more fragile. Nicotine in the cigarette slows down the production of bone forming cells that is osteoblasts so that they make less bone. Smoking decreases the absorption of calcium from the diet. Smoking also causes an imbalance in mechanism of bone turnover leading to decreased bone mass density or osteoporosis.

Smoking decreases blood supply for the fractured bone and increases time for bone healing. Bone healing requires adequate blood flow. Smoking causes decreased blood supply. Smoking increases time for ossification and remodeling following fractures, so the bone healing slows down. Air pollutant matters matter smaller than 2.5 micrometer causes decreased density and quality of bone.

Inhaling pollutant could lead to bone mass loss through oxidative stress and inflammation caused by air pollutant. Air pollutant decreases calcium absorption due to heavy intake of pollutant. Human body undergoes tremendous stress. It reduces calcium absorption thereby osteoporosis. Passive smokers are also at risk of osteopenia and osteoporosis.

Post smoking, harmful chemicals will spread and linger in home for 5 hours. Children breathe faster than adults, so they take more harmful chemicals with passive smoking. Children are also more sensitive to smoke than adults because of their bodies are young and are still developing. Healthy cells are attacked by free radicals causing oxidative stress and cell destruction. Antioxidant helps to repair the damaged cells by free radicals.
How air pollution degrades the bone health
Air pollution is also known to add to bone problems such as osteoporosis. If the elderly, who are frequently exposed to toxic airborne substances, are more likely to develop bone disorders. This is possible because air pollution and mineral density are related to the impacts of a mixture of substances. The effects might be noticed in the lumbar spine.

Numerous elements have been implicated in the possible detrimental effects of pollution on bone. In addition to increasing cytokines that activate bone cells (osteoclasts) that lead to bone loss, PM causes systemic inflammation. While some contaminants (such as metal compounds and gasses) serve as endocrine disruptors and impair bone cell function, others can destroy bone cells oxidatively.


The production and metabolism of vitamin D, which is essential for the intestinal absorption of calcium, may also be impacted by pollution. Because specific UV radiation wavelengths are required to produce vitamin D in our skin, high pollution levels can limit the quantity of UV light that reaches the planet.

Poorly mineralized bone can result from decreased skin production of vitamin D unless adequate vitamin D intake is obtained through food or supplementation.

(Author: Dr Shivangi Borkar, Head of the Department of Physiotherapy, P. D. Hinduja Hospital & MRC, Mahim)