To the Editor.
—Cigarette smoking has been consistently associated with osteoporosis1,2 and both appendicular3 and vertebral4 fractures. The increase in fracture risk is thought to be mediated by a decrease in bone density, but this has not been directly assessed for spinal fractures. We studied the relationship between cigarette smoking, bone density, and vertebral deformity in 300 elderly men and women participating in the Dubbo Osteoporosis Epidemiology Study (DOES).The city of Dubbo has a population of approximately 32 000 people and is situated 400 km northwest of Sydney, New South Wales, Australia. This community includes approximately 1600 men and 2100 women aged 60 years or older (as of January 1, 1989), 98.6% of whom are white. Subjects were invited to participate in DOES, which commenced in 1989. By the end of 1993, 1950 subjects (62%) of a surviving total target population of 2900 were participating. Using
Jones G, White C, Nguyen T, Sambrook P, Kelly P, Eisman J. Cigarette Smoking and Vertebral Body Deformity. JAMA. 1995;274(23):1834-1835. doi:10.1001/jama.1995.03530230020013