Tobacco and Musculoskeletal Health

You may already know that smoking and tobacco have been linked with lung and heart problems, as well as certain cancers. But most people don’t know that it’s also really bad for your bones and joints. Here’s what we know:

Smoking weakens your bones!

  • Smoking makes it harder for your body to absorb calcium from your diet. Less calcium can mean more fragile bones.
  • People who smoke have a greater chance of developing osteoporosis, a bone weakening that causes fractures. Elderly people who smoke are 30-40% more likely to break their hips than others like them that don’t smoke.
  • Nicotine slows your body down from making cells that build and repair bones. That means if you have a fracture, it can take longer to heal if you smoke.

Smoking can also effect muscles, tendons, and ligaments, increasing your chances of injury!

  • People who smoke are more likely to have traumatic injuries, like sprains or fractures.
  • People who smoke are 1.5 times more likely to have overuse injuries (tendonitis, bursitis, etc) than people who don't smoke.
  • Smoking has been connected with a higher risk of low back pain and arthritis.

Tobacco and Surgery

Smokers can have a lot more problems during and after surgery than people who don’t smoke. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke.

Why doesn’t my doctor want me to have surgery until I quit smoking?

Smoking can cause your blood pressure to be higher than normal, make it harder for your body to fight off infections, cause you to experience more pain, and slow down your healing after surgery. Your doctor wants your surgery to help you, and smoking can cause your surgery to be less successful.

But smoking won’t cause any serious problems after surgery, right?

Yes, it absolutely can! Patients that smoke increase their risk of blood clots developing after surgery. Blood clots can travel to the heart or lungs and cause serious damage, including death.  All smokers also carry an increased risk for other heart and lung problems.

If I smoke, can I just switch to smokeless tobacco or nicotine gum for surgery?

Your doctor doesn’t recommend using nicotine gum or other forms of tobacco around the time of surgery. The nicotine will still interfere with the healing of your surgical wound and have some of the same effects on your health as smoking.

Making the Decision to Quit

Quitting smoking & tobacco can be hard, but having a plan can help. There are many ways to quit smoking and many people you can talk to for help, such as:

  • Family members, friends, and coworkers may be supportive or encouraging.
  • Talk to your primary care doctor about ways they can help, including advice on medicines that may or may not work for you.
  • If you join smoking cessation programs, you have a much better chance of success. These programs are offered by hospitals, health departments, community centers, and work sites.

Plan for your quit day!

Choose a date ahead of time, but not too far ahead that it gets put off. Get rid of all your cigarettes, lighters, and tobacco products in advance. Tell your family and friends ahead of time so they can help support you. Make a plan for how to handle difficult situations or cravings – things will always come up, don’t give yourself an excuse to start smoking again!

I’ve tried to quit before and couldn’t, so what’s the point in trying again?

Don’t give up, you’re not alone! Most people who quit have tried and failed before. If you’ve tried before, take a look at what went well and what didn’t – learning from your past can help you succeed.

Where can I go for more information? has lots of resources to help you quit smoking. They can even connect you with a professional “quit coach” for free!  Calling 1-800-QUIT-NOW or going to, you will be linked up with a professional "quit coach" free of charge. This coach will have special training to help you kick the habit. The counselor will guide you through the resources available in your state and help you develop a quit plan.

About the Tallahassee Orthopedic Clinic and its Foundation

For over 35 years, TOC has provided the highest quality orthopedic and sports medicine care in North Florida and South Georgia.  TOC staff include 27 physicians with more than 300 employees, including PA’s, ARNP’s, RN’s, Certified Athletic Trainers, Certified Orthotics and an extensive support team of medical and technical assistants.  TOC provides a comprehensive Sports Medicine Program, a Regional Concussion Center, MRI services, an Orthotics and Prosthetics Division, Physical Therapy and an Outpatient Surgery Center.

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