Does Smoking Affect Fracture Healing?

Quitting smoking is better for fracture healing

Tobacco has been shown to be a contributory factor in delayed bone healing.

Smoking also adversely affects bone mineral density, lumbar disc degeneration, the incidence of hip fractures and wound healing. Clinical trials and demographic studies have reported poor prognosis for fracture patients who smoke.

Even giving up smoking 48 hours before an operation can improve outcomes for patients. If you smoke, this may be an opportune time to stop.

10 steps to Quitting

  • Write out your reasons for quitting
  • Pick a day and stick to it
  • Use the support of family and friends
  • Avoid routines or triggers that would normally prompt you to smoke
  • Get active
  • Don’t worry about a cough, irritability or poor sleep after giving up, it is a sign that the body is starting to heal
  • Deep breathe and the craving will pass after 3-5 minutes
  • Save money
  • Watch what you eat- avoid chocolate, sip a fruit juice


  • Effect of smoking on tibial shaft fracture healing. Schmitz et al. Clin Orthop Relat Res. 1999
  • Effect of nicotine on the rate and strength of long bone fracture healing. Raikin et al. Clin Orthop Relat Res. 1998
  • Cigarette smoking and bone healing: implications in foot and ankle surgery. Haverstock et al. J Foot Ankle Surg. 1998
  • Smoking and bony union after ulna-shortening osteotomy. Chen et al. Am J Orthop (Belle Mead NJ). 2001
  • The effect of smoking on clinical outcome and complication rates following Ilizarov reconstruction. McKee et al. J Orthop Trauma. 2003