Yashar Shahbaz
1 
, Rasoul Shirmohammadi
2 , Shirin Shamsghahfarokhi
3 , Hooman Esfahani
4 , Mobin Forghan
5 , Hojjat Eghbali Jelodar
5 , Leila Ashrafi
6 , Mohammad Mousavi
6* 1 Orthopedic Research Center, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Department of Orthopaedic Surgery, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
3 Department of Internal Medicine, School of Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
4 Department of Emergency Medicine, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
5 Department of Surgery and Orthopedic, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
6 Department of Internal Medicine, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Abstract
Cigarette smoking represents a major lifestyle risk factor for bone loss and skeletal disorders, with complex etiological mechanisms consisting both direct tissue effects and systemic alterations. Recent evidence demonstrates that tobacco smoking triggers an intricate cascade of cellular and molecular events that disrupts the delicate balance of bone remodeling, finally leading to decreased bone mass and increased fracture risk.