This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system.
A comprehensive search of PubMed, Web of Science, and Science Direct returned articles meeting inclusion criteria. A majority of studies found smoking has negative effects on the musculoskeletal system.
In research on bones, smoking was associated with lower BMD, increased fracture risk, periodontitis, alveolar bone loss, and dental implant failure.
In research on joints, smoking was associated with increased joint disease activity, poor functional outcomes, and poor therapeutic response. There was also evidence of adverse effects on muscles, tendons, cartilage, and ligaments.
There were few studies on the musculoskeletal health outcomes of secondhand smoke, smoking cessation, or other modes of smoking, such as waterpipes or electronic cigarettes. This review found evidence that suggests tobacco smoking has negative effects on the health outcomes of the musculoskeletal system.
There is a need for further research to understand mechanisms of action for the effects of smoking on the musculoskeletal system and to increase awareness of healthcare providers and community members of the adverse effects of smoking on the musculoskeletal system.
Introduction Tobacco smoke has more than 7, harmful chemical compounds that enter a human body either directly through smoking, indirectly through secondhand exposure to smoke exhaled by a smoker, or through downstream smoke released from a cigarette or pipe [ 1 ].
Both smokers and nonsmokers are at risk of exposure to the compounds of smoked tobacco that accumulate on the surfaces in a poorly ventilated environment; this method of exposure is known as thirdhand smoke exposure [ 2 ].
In the United States, there are approximatelyannual deaths causally related to smoking and secondhand exposure to smoke [ 3 ]. Tobacco smoking has known adverse consequences on most human body systems.
Researchers have focused more attention on the deleterious effects of smoking for high mortality diseases, such as cancer and diseases of the cardiovascular and respiratory systems, with less research attention on other body systems, such as the musculoskeletal system [ 3 ].
The musculoskeletal system is one of the largest human body systems, comprised of bones, joints, muscles, cartilage, tendons, ligaments, and other connective tissues [ 4 ]. An intact and functioning musculoskeletal locomotor system is necessary to perform activities of daily living and maintain quality of life [ 56 ].
Several studies have investigated the association between smoking and musculoskeletal disorders. According to the recent Surgeon General report, the causal relationship between tobacco smoking and rheumatoid arthritis, periodontitis, and hip fractures has been confirmed [ 3 ]; however, there is inconclusive evidence to support causality between smoking and many other musculoskeletal disorders.
Searching online databases revealed significant growth in the body of literature investigating relationships between tobacco smoking and the musculoskeletal system. During our comprehensive online search, we did not encounter any systematic reviews examining those relationships; however, we did find 10 systematic reviews of the effects of tobacco smoking on components of the musculoskeletal system.
Five systematic reviews focused on smoking and the effects on dental implants and found smoking increases the risk of peri-implant bone loss and implant failure [ 7 — 11 ]. Another systematic review revealed an association between smoking and lumbar disc herniation [ 12 ]. Three other reviews found smoking was related to negative postoperative outcomes on knee ligaments [ 13 ], higher complication rates after anterior cruciate ligament ACL reconstruction [ 14 ], and slowed healing of rotator cuff repair [ 15 ].
Also, one review found smoking was associated with rotator cuff tears and other shoulder symptoms [ 16 ].
Our review will be the first to collect and assess all the recent literature on the effects of smoking on the musculoskeletal system. This systematic review will orient scientists interested in the health effects of smoking about the state of the science over the last decade as they conduct more advanced research.
Also, the amalgamation of these data in one document will be helpful to the research community as there is a high degree of similarity and shared characteristics between musculoskeletal system components. This systematic review evaluated literature published in the last decade to summarize the evidence regarding the effect of smoking on the musculoskeletal system.
This systematic review will answer two main questions: Is there an association between tobacco smoking and musculoskeletal health? What are the effects of tobacco smoking on the musculoskeletal health?
Before the onset of the systematic review, a specific protocol was developed to minimize bias. This protocol included a priori research questions, a comprehensive literature search, inclusion criteria for studies, screening methods and reasons for exclusion, data abstraction, scientific study quality, data analysis, and synthesis.
This search covered 10 years from January 1,to March 18,and included only articles written in English.
The search strategies included a combination of the following key words: This step was helpful to expand the search; for example, the entry terms for MeSH of smoking were as follows: All retrieved records were pulled from databases using EndNote X7.
After that, abstracts of the retained records were screened for inclusion criteria: English language, human subjects, published January 1, —March 18,and investigating effects of smoking on the musculoskeletal system.NMN EIU Non-covered Service Med Policy Criteria _ICD9 ICD9 CODE POLICY Description Osteocalcin (bone g1a protein) EXPERIMENTAL, INVESTIGATIONAL, UNPROVEN.
NMN EIU Non-covered Service Med Policy Criteria _ICD9 ICD9 CODE POLICY Description Osteocalcin (bone g1a protein) EXPERIMENTAL, INVESTIGATIONAL, UNPROVEN. This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system. AMSTAR criteria were followed.
A comprehensive search of PubMed, Web of Science, and Science Direct returned articles meeting inclusion criteria. A majority of studies found smoking has negative effects on the musculoskeletal system. This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system.
AMSTAR criteria were followed. A comprehensive search of PubMed, Web of Science, and Science Direct returned articles meeting inclusion criteria.
A majority of studies found smoking has negative effects on the musculoskeletal system.