Weight changes after smoking cessation and the risk of hip fractures: a nationwide population-based cohort study
Authors' conclusion
Smoking cessation was associated with a lower risk of hip fracture than continued smoking, although the risk remained higher than in nonsmokers. Weight loss after smoking cessation was associated with higher fracture risk, while maintaining stable body weight appeared to be associated with more favorable outcomes.
Study context
- Population
- Adults aged ≥ 40 years with consecutive biennial health examinations in 2007 and 2009, Korean National Health Insurance Service; followed 2010–201834,143 quitters
- Participants
- 913,805 adults
- Exposure
- Quitters and current smokers vs nonsmokers
- Nonsmokersn = 672,858reference
- Current smokersn = 206,804
- Outcome
- Incident hip fractures
Methodological detailsnationwide, population-based, multivariable Cox proportional hazards models
- Nationwide
- Population-based
- Multivariable Cox proportional hazards models
Main finding
As reported in the abstract
Hip fracture
Each group vs nonsmokersAdjusted hazard ratio (95% CI)
Current smokers
1.700(1.557–1.856)
Quitters, weight loss
1.878(1.164–3.031)
Quitters, weight maintenance
1.461(1.188–1.797)
Quitters, weight gain
1.611(1.151–2.255)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Hip fracture by weight change, entire cohort (vs weight maintenance)Weight lossvs Weight maintenance | 1.425 (1.336–1.519) | |
| Hip fracture by weight change, entire cohort (vs weight maintenance)Weight gainvs Weight maintenance | 1.150 (1.064–1.242) | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Weight changes after smoking cessation and the risk of hip fractures: a nationwide population-based cohort study. Osteoporos Int. Published 19 June 2026. doi:10. 1007/ s00198-026-08119-x
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