In 1964, the Surgeon General warned the American public of a definite association between smoking and lung cancer.105 Since this report we have become increasingly aware of other harmful effects, including peripheral and cardiovascular disease as well as other forms of cancers. Although smoking rates have declined, 26 percent of American adults continue to smoke. The individual who smokes not only places him or herself at risk, but also places others in danger through the emission of passive smoke. Society must bear the cost for the smoker's habit, but unlike many risk factors for disease, smoking represents a factor which can be minimized or even eliminated.
Smoking affects every organ system in the human body, including those of the musculoskeletal system. The deleterious effects are dose-related, and at least partially reversible by the cessation of smoking. Unfortunately, smoking usually begins under the age of 21, and frequently continues throughout life.7 As the treatment for tobacco-related heart and lung disease becomes more successful, and people who smoke live longer, these musculoskeletal effects will become increasingly evident.
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