Cigarettes increase the risk of fragility fractures, particularly of the hip and spine. The negative effects of nicotine also slow down recovery after surgery
Not just cancers, cardiovascular and respiratory diseases. Smoking among the scientifically certain causes of 25 different diseases and to the list of health damage caused by tobacco must also be added those on muscles and bones, less known to many people, but potentially responsible for considerable complications in the outcome of orthopedic interventions among the most common. Precisely to better inform the population and raise awareness of both specialists and patients, the Italian Society of Orthopedics and Traumatology (Siot) conducted a survey and drafted a handbook presented recently in the virtual forum Combat smoking to the bone. The consequences of smoking on bone health are an issue that is often underestimated or completely ignored by public opinion – says Francesco Falez, past president Siot -. In some cases, fortunately a minority, even by the specialists themselves. Through this research and the virtual forum we wanted to promote an action of comparison, first of all among orthopedists, to improve awareness among patients and identify different strategies, aimed at reducing the negative effects of smoking on the health of the musculoskeletal system. and incentivize people to quit.
Tobacco also affects post-intervention recovery
According to the data that emerged from the interviews conducted by the Ix Institute on behalf of Siot on over 800 citizens of age (smokers and non-smokers), about 350 specialist doctors and 100 patients, 89% of orthopedists are aware of the serious problems caused by muscle tobacco and bones, but only 61% of Italians know this negative effect. And the percentage rises very little between those who have had pathologies or interventions (62%) and smokers (64%). The best known consequences are the degeneration of the cartilages, the greater risk of infections in case of surgical operations, longer times in the repair of bone fractures, injuries to the tendons. Six out of 10 respondents also know the danger of osteoporosis, with a consequent increase in the number of fractures. Tobacco also has a profound effect on the healing process from musculoskeletal pathologies and surgical interventions: something that specialists are well aware of (92%), but which almost half of people ignore.
Known consequences of tobacco on bones
The damage of smoking on bones is documented by numerous scientific studies – remembers Falez, director of Orthopedics and Traumatology at San Filippo Neri in Rome -: it negatively affects the density and quality of the bone, increases the risk of fragility fracture (in particular of the hip and spine), increases the possibility of superficial and deep infections of the soft and bone tissues in all operations, reduces the success of the osteo-integration processes in prosthetic surgery. And not only. It slows down the healing processes of surgical wounds due to the anticoagulant effects of nicotine and, in the event of traumatic events, delays the healing of fractures, negatively impacting bone fixation. If on the one hand the purpose of the decalogue is to inform the population about the risks associated with cigarettes, on the other hand it seeks to identify damage containment strategies in which orthopedists can certainly play a decisive role. the informed consent that specialists present to their patients treat smoking complications. And if 63% of patients say they have received questions about their possible smoking habits during the interview, 23% of those interviewed say that the topic has not been dealt with.
The role of orthopedists
The part of the population that has had to deal with orthopedists is more informed than the average, even if not to a significant extent – comments Margherita Sartorio Mengotti, CEO of the Ix Institute -. Patients are aware that the damage caused by smoking can be of considerable magnitude, but there is ample room for improvement because the segment of the population that ignores the risks remains extended even in the case of pathologies to the musculoskeletal system. intervention by orthopedists can be decisive: During the interview, the patient’s smoking habits must be carefully evaluated – concludes past president Siot -. We can and must adapt informed consent, alert patients to the risks and invite them to stop, especially in view of an intervention.
Therapy or psychological support to quit
Smoking continues to be the leading preventable cause of death in the whole West and kills more than 70,000 people every year in our country, yet nearly 11 million Italians (over 23% of the population) light cigarettes every day. Many smokers try to quit, often on their own, and fail several times (on average four) before they succeed. Statistics in hand, asking for help from an anti-smoking center (the toll-free number of the Istituto Superiore di Sanit 800.554.088) can make the difference and contribute to the success of the company. the smoker patient stopped smoking, about half of the specialists invited at least to reduce its consumption and suggested a method to say goodbye to tobacco, such as the possibility of contacting a center specialized in drug therapy or psychological support.
April 9, 2022 (change April 9, 2022 | 19:54)
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