Association of Smoking and Osteoporosis in Men: a Secondary Data Analysis from the National Health and Nutrition Examination Survey (NHANES) 2013–2014

People that smoke may develop an increased risk of osteoporotic fractures independent of smoking status, gender, and age. The increase of osteoporotic fractures may be moderate but attributed to an increased clinical impact and substantial healthcare spending, especially in the geriatric population. The study analyzed the data for all 2,290 male respondents from the National Health and Nutrition Examination Survey (NHANES) 2013–2014, who were aged 30 years and above for whom a smoking status and femoral neck bone mineral density (BMD) scan were obtained. An ANOVA was used to examine the differences between never, former, and current smokers. A simple linear regression analysis was conducted to find the association between smoking and femoral neck BMD as a function of osteoporosis in men who were never smokers, former smokers, and current smokers. Smoking duration was statistically significantly associated with decreased femoral neck bone mineral density in former smokers (p < .001). Among current smokers, duration of smoking was statistically significantly associated with decreased femoral neck bone mineral density (p < .005). The overall femoral neck BMD in the sample population was not statistically significant even after adjusting for multiple covariates, including age, race, general health condition, annual household income, and cortisone/prednisone use (p < .05). These findings support that a public health mandate be adopted to help the male population to quit smoking. Future implications and best strategies need to be devised for screening of osteoporosis in men