{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:35:28Z","timestamp":1787016928898,"version":"build-2736575974"},"reference-count":46,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The North Norway Regional Health Authority","award":["SFP1291-16"],"award-info":[{"award-number":["SFP1291-16"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,4]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the longitudinal associations between tobacco use (smoking and snuff) and bone mineral density (BMD) at femoral sites and in the total body in a Norwegian adolescent cohort, aged 16\u201327 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A population-based study in Norwegian adolescents from the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>In total, 722 adolescents (385 females and 337 males) with a mean age of 16 years (SD: 0.5) from the Fit Futures Study (FF) were included at FF1 (2010\u20132011), with follow-up measures at age 18 years (FF2 (2012\u20132013)) and 27 years (FF3 (2021\u20132022)). Inclusion criteria were completed dual-energy X-ray absorptiometry (DXA) scans, serum vitamin D blood samples and information on smoking, snuff use, physical activity, height, alcohol intake, hormonal contraceptive use and puberty status, all at baseline (FF1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Associations between self-reported smoking and snuff use (categorised as never, sometimes or daily) and changes in BMD (g\/cm\u00b2) at the total hip, femoral neck and total body, measured using DXA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Total hip BMD (mean (g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ), 95%\u2009CI) slightly increased from FF1 (females: 1.066, 95% CI 1.054 to 1.079; males: 1.121, 95% CI 1.105 to 1.136) to FF2 (females: 1.076, 95% CI 1.063 to 1.089; males: 1.141, 95% CI 1.126 to 1.157; p&lt;0.001), but thereafter decreased to FF3 (females: 1.050, 95% CI 1.036 to 1.063; males: 1.091, 95% CI 1.074 to 1.107; females and males, both p&lt;0.001). Similar patterns were observed for the femoral neck, while total body BMD increased from FF1 through FF3 (p&lt;0.001). We observed interactions between time and smoking and between time and snuff use in all models (all p&lt;0.001). However, we generally observed no statistically significant differences in BMD levels across smoking and snuff use groups at different time points (all p&gt;0.07), except in females at 18 years (FF2), where those who never smoked had higher total hip BMD than those who sometimes and never smoked (p&lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found no statistically significant associations between smoking or snuff use and BMD levels in Norwegian adolescents from a median age of 16 to 27 years. Notably, only 2.6% of females and 3.9% of males reported smoking daily. However, in this study, moderate tobacco use did not appear to negatively influence bone growth from adolescence to young adulthood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101654","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T19:15:38Z","timestamp":1756667738000},"page":"e101654","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Does tobacco use influence bone mineral density levels in a Norwegian youth cohort followed from adolescence to young adulthood? 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