Puffing away to reduce surgery

Smoking will increase your risk of cancer, emphysema, heart disease, stroke, and could cause premature death, but if you manage to dodge all those bullets, puffing on a cigarette may reduce your need for joint-replacement surgery later in life.

The surprising results of a new study has found the longer men smoked, the less likely they were to undergo surgery to replace hips and knees damaged by arthritis or other conditions.

The study’s participants included about 11,000 older men in Australia. Those who smoked for 48 years or more, the bulk of their adult lives, were 42% to 51% less likely (depending on their age) to need the surgeries than men who had never smoked, according to the study appearing in the journal Arthritis & Rheumatism.

Previous studies have shown a similar link, but this was the first to show a clear relationship between the number of years spent smoking and the likelihood of joint-replacement surgery.

Lead researcher and PhD candidate in public health at the University of Adelaide, Dr George Mnatzaganian, said he could not “fully explain the findings”.

Obesity and habitual vigorous exercise both increase the risk of arthritis and also tend to be less common among smokers, but the link between smoking and joint replacement remained even when the researchers took those factors into account.

Laboratory experiments using animals and human tissue have suggested nicotine may stimulate the activity of the cells found in joint cartilage, which could help lessen the severity of osteoarthritis.

“What we would like to see now is increased research by laboratory and clinical scientists, so we can clarify the exact mechanisms by which smoking confers protection on weight-bearing joints,” Dr Mnatzaganian said.

“If this led to development of new preventative or treatment strategies then, eventually, we might reasonably expect to see a fall in the need for major joint replacement,” he said.

However, Dr Mnatzaganian was quick to point out that smoking is not the answer to joint health.

“Whatever new preventative or treatment strategies may be developed in the future, they will certainly not include smoking,” he said.

Arthritis researcher and professor of medicine at the University of North Carolina at Chapel Hill, Dr Leigh Callahan, said the findings were likely to spur scientists to explore the relationship between smoking and arthritis more closely.