The Joint Effort Podcast

Stronger Bones, Better Joints: Why Smoking Cessation Matters

• Dr. Noelle DiGioia Guthrie & Tiffany Belculfine, PA • Episode 6

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0:00 | 14:06

What’s The Role Of Smoking Cessation In Bone And Joint Health?

Stiff knees, slow healing, and nagging pain don’t just “happen”—they build from small choices we repeat every day. We dig into the habits that quietly shape bone and joint health, from nicotine’s chokehold on blood flow to the overlooked math of body weight multiplying pressure on your knees. Along the way, we break down how alcohol disrupts calcium absorption, why sugar spikes inflammation, and how a smarter plate can lower pain while supporting faster recovery after surgery or injury.

You’ll hear clear, real-world guidance on what to change first and how to keep going when life is busy. We explain why movement truly works like medicine for osteoarthritis, how synovial fluid lubricates joints when you stay active, and why starting with two or three minutes of daily walking can unlock momentum. We also compare activities like swimming and weight-bearing exercise, explore options for highly trained athletes versus everyday walkers, and offer strategies for people with sedentary jobs, long commutes, or on-the-go eating.

Expect practical takeaways you can use today: build a simple movement routine, choose anti-inflammatory foods that fit your schedule, set small goals that snowball, and seek help for smoking cessation, weight management, or alcohol reduction. Stronger hips and knees come from repeatable steps, not perfection. Subscribe, share with a friend who needs a nudge, and leave a quick review to tell us your first habit change—we’re cheering you on.

To learn more about The Bone and Joint Center at Magee-Womens Hospital visit: https://www.pghbjc.com
Dr. Noelle DiGioia Guthrie
300 Halket St.
Pittsburgh, PA, 15213
412-683-7272

To learn more about The Wellness Center for Bone and Joint Health visit: https://www.boneandjointhealth.org
Tiffany Belculfine
300 Halket St., Suite 1601
Pittsburgh, PA, 15213
412-641-8594

SPEAKER_00:

Welcome to the Joint Effort Podcast, where mobility meets reality and your future self says thank you. Your host, Dr. Noel DeJoy Guthrie of the Ponent Joint Center of the Key Women's Hospital. And Tiffany Elkafine, position assistant at the Wellness Center of the Owning Joint House, serving adults across Western. If you're putting on stops, we're side eye. You're in the right place. Every day, they'll break it down and build you back up with a personalized plan for real life. The show is information without a substitute clinician. Now, let's get you moving. Here are Dr. Noelle and Tiffany.

SPEAKER_01:

Small daily habits can quietly shape your long-term mobility. And today we are unpacking why they matter more than most people realize. Welcome everyone. I'm Julie Schwenzer, co-host and producer in the studio with Dr. Noelle DeJoya Guthrie of the Bone and Joint Center at McGee Women's Hospital, and Tiffany Belcofine, physician assistant at the Wellness Center for Bone and Joint Health. Ladies, it's so great to chat with you again.

SPEAKER_03:

Yes, thank you.

SPEAKER_01:

Thank you. So, Tiffany, if we can dive in with you, what's the role of smoking cessation in bone and joint health?

SPEAKER_03:

So, a lot of things that people don't realize about smoking is the cumulative effect it can have over time. So not only can it affect the amount of calcium in our bones, but it's also a big risk factor for people if they are undergoing a joint replacement surgery. That could lead to poorer outcomes in many cases for people who do smoke. That can lead to problems with wound healing, with um increased pneumonia risks after surgery, and really just not having the amount of blood flow that they need to achieve proper results.

SPEAKER_01:

And what about um nicotine's impacts on your inflammation and also um healing time after any operation or just trying to get past some issues with your health?

SPEAKER_03:

Definitely. So every little bit that people are able to decrease their tobacco intake or their nicotine intake also reduces the amount of inflammation in their body. And when people have less inflammation, they're going to have less pain and they're going to have better outcomes after a surgery.

SPEAKER_02:

Nicotine's um uh physiologically, it causes your your um vessels to constrict, mean get smaller. So the blood flow can't get to the areas where it needs to go um as easily. So, particularly when you're having surgery, um, it's really important for blood flow, which carries healing properties and you know, growth factors and anti-inflammatory factors, oxygen um to help heal and um, you know, make you feel better after surgery. You're not able to do that as well. So it's really important on the preoperative side to to optimize um smoking, meaning stop smoking completely if patients can or work with them to decrease as much as they can before surgery. And then hopefully that helps them afterwards too to um to continue with their smoking sensation just for a better lifestyle in general.

SPEAKER_01:

Do you see big differences in the rate of improvement in somebody's health if they were a long-term smoker and quit versus somebody who only smoked maybe for several years and then quit?

SPEAKER_03:

You know, any any tobacco-free week that someone is going to have after surgery is going to increase their outcomes of how well that they do. So it's not necessarily even that people have only been smoking for a little bit of time. Like once it's in there, it really does the damage pretty quickly.

SPEAKER_01:

Oh, thank you for answering that. And another question, too, about lifestyle choices what about alcohol? How does that impact everything?

SPEAKER_03:

Yes, alcohol is another one that can also slow down wound healing for our post-op patients. And it's also something else that can affect the amount of calcium and the way that calcium is absorbed properly in the bones. So it can lead to those bones being weaker, it can lead to poorer surgical outcomes of people not being able to achieve that wound healing. Again, um, all of those risky substance behaviors really do put people at a lot more risk than they realize.

SPEAKER_02:

And similar to smoking, I think alcohol, you know, in general, having a lifestyle with, you know, increased alcohol intake, smoking intake, it just um, you know, surgery itself is a stressor on your body no matter what it is. And so afterwards, having those pre-op risk strat risk factors increase puts you increased risk for other, you know, issues, not just with your knee or your hip, but with your heart, your lungs, your brain and stuff like that. So, you know, while surgery is a stressor and then stresses those parts of your body as well, we want you to be optimally um medically stable before surgery.

SPEAKER_01:

And what about choices with um processed sugar and other foods that aren't considered really, you know, food to some people?

SPEAKER_03:

Yeah. So obesity is a very challenging risk factor for lots of different health conditions, you know, not just our bone and joint health, but when it comes down to it, every extra pound of weight that a person is carrying around is putting five to six extra pounds of pressure and force and stress on their joints. So if people are not able to achieve a healthy body weight before a planned surgery, they have the risk of damaging not only their native joints, but also the joint that is being replaced. And that may lead to needing revisions sooner or the, you know, the process not taking as well as it could otherwise.

SPEAKER_02:

Processed sugars like that, those are pro-inflammatory things. You know, we actually have a really cool um, you know, recipe book that has recipes that are anti-inflammatory, um, gluten-free, stuff like that that actually is um pro-anti-inflammatory. So, you know, it does make a difference what you eat on the inflammation in your body.

SPEAKER_01:

Sure. And what about athletes and you know, injuries that they may um they may encounter, or um maybe they're just harder on their, you know, on their joints. How about that type of choice in their lifestyle?

SPEAKER_03:

Well, you know, people who are athletes are completely at a different level than the rest of the general population. Um, you know, they are educated a little bit better on what their body needs to do in order to recover from a stress or from an injury. And they definitely have a higher level of training. So they are much more prepared to let their bodies accommodate those additional stressors of an injury than just people who, you know, their their exercise involves walking. So it's a very different circumstance to deal with athletes who are, you know, highly conditioned, highly trained. Um, you know, the things that they can do with their bodies, most people can't do with their bodies, and that's a big factor.

SPEAKER_01:

So do you see like swimmers ever that come in or they just are never patient?

SPEAKER_03:

Well, we focus mostly on hips and knees. So we do avoid those folks. But you know, it's tricky because swimming is such a good exercise for keeping your joints loose. It doesn't put the weight-bearing stress on your joints. So if you have painful joints, swimming is a great option for you. But also, if we're trying to get your bones stronger from like an osteoporosis or osteoarthritis standpoint, swimming isn't going to do as much because it's not that weight-bearing activity. So each activity that we choose is going to have different impacts on different sources of our body.

SPEAKER_01:

Yeah, that's a great point. Um, so what lifestyle habits would you, and I know it's hard to say because you have um patients that you see that are, you know, at all all different points in their life and their health, but um, what do you wish more patients would understand as what you two would consider joint health essentials?

SPEAKER_03:

I think the thing that most people need to know is actually twofold. Um, that food and movement are both medicine. Both of those things can affect the way that people feel in either a good way or a bad way. If they're not moving enough, they're not going to feel well. When they need to get up and move around, they're not going to be able to do that. If they're moving regularly, they're going to be able to stay limber. They're going to be able to bend over and tie their shoes better. They're going to be able to go up and down those stairs better. They're going to maintain those life skills. And the same with nutritional factors. You know, food can either heal us or food can harm us. So knowing what people need to choose food-wise to calm down inflammation, keep their BMIs under control, and making those better choices when they can. Nobody's perfect, but making those choices when they can is a really good way to incorporate letting our body heal itself via food. Um, and certainly the foods that we choose, like I said, can go either way. So we want to make sure we're choosing more of the things that help us and less of the things that harm us.

SPEAKER_02:

I can't emphasize enough that movement is medicine too. I think people, particularly with arthritis, when you're moving, it hurts sometimes. But the more you move, it feels better. Very typical of osteoarthritis. I think you're stiff when you're not moving. Then as you move, your joint feels better because your synovial fluid actually produces more when you're moving and it actually lubricates your joint and makes you feel better. So some people say, oh, I'm not gonna go play tennis, I'm not gonna go play pickleball, I'm not gonna exercise because it hurts, but actually it's good for you. Um, we can't emphasize that enough, particularly in the population that we see that movement is good. Um, you know, I think there's a point where people just want to stop and do nothing, but that's not a right way to go about it.

SPEAKER_03:

Yeah. And I think it's also important for people to realize that they don't have to be at the level of walking an hour a day. They have to start somewhere. So every little bit that they can do is going to increase them closer to that goal. So maybe they can walk for two or three minutes a day. That's where we start. You can build on that from there. Because if two or three minutes is easy for you, maybe you can do five minutes and we can increase them slowly. And then as she was saying about, you know, the movement being medicine, one example I love to use with my patients is if you've ever been on a long car trip, the first time you get to the rest stop or your destination, the first thing you want to do is stand up and stretch and wiggle and move your body around. That's because our bodies are made for movement. They're not made to be stuck in that sitting position, not able to move, not able to stretch, not able to do the things that it does. So yeah, it's so important for people to know that those little bits every day of the movement is just going to do amazing things for them long term.

SPEAKER_01:

Do you ladies see a lot of like long distance truck drivers or people in positions where they're just, you know, or office jobs where they're sitting all day? Is that something that you see a lot too?

SPEAKER_03:

Definitely. Definitely. And that's, you know, across all age groups. Even if someone has retired from a profession like that, if it's something they did before, you know, if they're working very long hours or they're stuck sitting at their desk or they're driving a vehicle like that long term, that's something that puts a lot of stress on their body because they can't move. And unfortunately, a lot of times in those circumstances, people can't eat well either. They don't have the ability to pull over and take time to eat and, you know, choose a salad. They have to find things that are easy for them on the go while they're on this timed route and the things that they have obligations for. So unfortunately, those changes really are harder, you know, once people have had that lifestyle in place for a long time.

SPEAKER_01:

And a last question for the both of you if somebody is ready to make some lifestyle changes and to improve their bone and joint health, what would you recommend? And let's say it's like a poster child for everything that we've been talking about. It's somebody smoking, drinking, not exercising, picking bad food choices, you know, things like that. Um, what could be the first small step that you could take to make a big difference in their life?

SPEAKER_03:

I think the first thing needs to be that they need to get that movement, really and truly. They need to realize that, you know, movement affects so many things in our body. It affects the way that we sleep, it affects our mental health, it affects our physical health, it affects the way our blood flows, it affects if we have, you know, too much swelling in our legs. It there's so many things that trickle down from not having that movement portion in place. And that's where everybody needs to start.

SPEAKER_02:

And I think like Tiffany mentioned, setting small goals for yourself. You know, you're not going to be running a marathon in a week, but you know, maybe start with 15 minutes and then slowly work up to 30 minutes. I think that's really important too, you know, and once you it feels good to achieve a goal. So set a small goal, achieve that, you know, raise the bar a little bit. And also don't be afraid to ask for help. We we have a, you know, most places um have great resources, uh, be it for uh weight management, smoking cessation, you know, alcohol use, you know, to help. Um, I think that's really important too. And even just with movement, go with a friend, you know, the communities are really important too.

SPEAKER_01:

Well, thank you both. Thank you, Tiffany. Thank you, Dr. Noel. And I think you both have dogs too, right?

SPEAKER_03:

Yes.

SPEAKER_01:

So a lot of dog walks.

SPEAKER_03:

You know, even if it's super cold outside, I mean, can you take your dog to the mailbox and back? Um, you know, it's good for your dog, it's good for you. Everybody wins.

SPEAKER_01:

Yeah, happy dog, happy home, right? Yes. Well, thank you for breaking that down so clearly. We really appreciate the both of you. Thank you so much, Julie.

SPEAKER_00:

That's today's dose of strength, balance, and better movement from the Joint Effort Podcast. Ready for care that fits your life and gets you moving? To schedule an appointment with Dr. Noel for your surgical and injection needs, call 412-683-7272. Or visit PGHBJC.com. Or if you are looking for lifestyle changes that are not surgical, contact Tiffany Belkenfind. Call 412-641-8594, or visit bone at jointhealth.org. Healthy bones and happy joints make every day better. Until next time, keep moving, stay steady, and take care of yourself.