Smoker's Bones

Washington - Smoker's broken bones take a lot longer to heal. But scientists now are studying whether giving up cigarettes for even a week or two after a fracture might make the difference between a speedy recovery and months of easy-to-reinjure mushy bones.

"There's a window," predicts orthopedic specialist Michael Zuzscik of the University of Rochester.

If he's right, it could dramatically change orthopedic practice for the nation's 48 million smokers.

Bone damage is arguably the least publicized of tobacco's harms.

The first time many many smokers ever hear of the problem is if they need spinal fusion, a back operation that surgeons often won't perform unless the patients kick the habit with a urine test to prove they quit. That's because the surgery is far more likely to fail in smokers than non-smokers.

Smokers who break a leg require 62 percent more time to heal.

Then there's the silent toll smoking can wreak by contributing to bone-thinning osteoporosis.

Yet tobacco's nicotine provokes a powerful addiction; it can take repeated attempts to succeed in quitting. Those who do often use nicotine patches or gum to wean themselves.

Here's the rub: Zuscik's early research suggest nicotine may be a key bone-damaging culprit - and that is does its dirty work almost immediately by affecting stem cells stored in the bone marrow, called mesenchymal stem cells, that move in to be grin healing an injured bone. "The most important steps that occur involving these mesenchymal stem cells happen during the first days and weeks of the healing process." Zuscik explains. "The whole thing is kind of derailed."

Now, armed with a new $1.4 million grant from the Defense Department, Zuscik is out to prove that theory, and whether going cold turkey for a short time after breaking a bone or undergoing bone surgery might help smokers heal faster.

But the Rochester team's theory is plausible, he says. And its crucial to pursue because if they're right, using nicotine patches or gum immediately after a bone injury would likely be as bad as continuing to smoke.