Smoking remains the number one cause of preventable death. Each year more than 440,000 people in the United States alone die from tobacco-related diseases. In fact, smokers can expect to live 7 to 10 years less than nonsmokers.

Smoking is linked to heart and respiratory diseases and to several cancers. In addition, smoking has a significant impact on your bones and joints.

Every tissue in the human body is affected by smoking, but many effects are reversible. By avoiding or quitting smoking, you can reduce your risk for incurring many conditions. Quitting smoking can also help your body regain some of its normal healthy functioning.

Here's what scientists have found about the relationship between smoking and musculoskeletal health.

• Smoking increases your risk of developing osteoporosis.
• Smoking has a detrimental effect on bone density.
• Studies have shown that smoking reduces the blood supply to bones and that nicotine slows the production of bone-forming cells (osteoblasts) and impairs the absorption of calcium. With less bone mineral, smokers develop fragile bones (osteoporosis).
• Smoking also reduces the protective effect of estrogen replacement therapy.
• Smoking increases your risk of a hip fracture as you age.
• Osteoporosis is often a risk factor in hip fractures. Elderly smokers have a 30-40 percent increase in the rate of hip fracture.

Smoking increases your risk of developing exercise-related injuries.

• Rotator cuff (shoulder) tears in smokers are nearly twice as large as those in nonsmokers.
• Additionally, a study of young Army recruits showed that smokers were 1.5 times more likely to suffer overuse injuries such as bursitis or tendonitis than nonsmokers.
• Smokers were also more likely to suffer traumatic injuries, such as sprains or fractures.

Smoking has a detrimental effect on fracture and wound healing.

• Fractures take longer to heal in smokers because of the harmful effects of nicotine on the production of bone-forming cells.
• Smokers also have a higher rate of complications after surgery than nonsmokers, and outcomes are less satisfactory.
• Smoking has a detrimental effect on athletic performance.
• Because smoking slows lung growth and impairs lung function, there is less oxygen available for muscles used in sports. Smokers suffer from shortness of breath almost three times more often than nonsmokers. Smokers cannot run or walk as fast or as far as nonsmokers.
• Smoking is associated with low back pain and rheumatoid arthritis.