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March 29, 1976

Osteoporosis Among Women Who Smoke Cigarettes

JAMA. 1976;235(13):1367-1368. doi:10.1001/jama.1976.03260390053037

In the current issue of Archives of Internal Medicine (136: 298-304, 1976), Daniell observes that progressive osteoporosis is apparently universal among postmenopausal women and lists factors that have been considered to play a contributory role. Among the more common factors are small constitutional size, a genetic predisposition including white ancestry, deficiencies of calcium and sex hormones, inactivity, and aging. Less frequent factors are thyrotoxicosis, malabsorption syndromes, the postgastrectomy state, collagen diseases, sustained corticosteroid excess, alcoholism, hyperthyroidism, and chronic uremia.

In an earlier article,1 Daniell noted that middle-aged men and women with symptomatic osteoporosis were almost exclusively heavy cigarette smokers. This observation led him to pursue two further studies in women: the incidence of vertebral compression fractures and the degree of bone density as determined by roentgenographic examination of the second metacarpal bone.

Accordingly, the author examined the hospital records of women between the ages of 40 and 70 years