Smoking has significant negative effects on bone health. Starting from adolescence, smoking can prevent the development of maximum bone mass, leading to a smaller skeleton and less bone density compared to non-smokers. In adults, especially women in their 40s and 50s, smoking accelerates bone loss by reducing estrogen levels, which are crucial for maintaining bone health. Cigarette smoke generates free radicals that damage cells, organs, and hormones necessary for bone maintenance. Nicotine and other toxins in cigarettes disrupt the balance of hormones like estrogen and increase levels of cortisol, which leads to bone breakdown. Additionally, smoking impedes the function of calcitonin, a hormone that helps build bones, and kills osteoblasts, the cells responsible for bone formation. Poor blood supply due to damaged blood vessels also hampers bone healing and increases the risk of fractures. Quitting smoking can improve bone density over time, as shown in studies where postmenopausal women had better bone density after one year of not smoking. Quitting smoking involves setting a quit date, seeking support, using medication, and changing daily habits that are associated with smoking.