Johnson JE, et al. - Authors ascertained the distal radius microstructure and macrostructure differences between smokers and non-smokers. They also determined the degree to which smoking was correlated to compartment-specific mechanical differences resulting from compromised cortical-trabecular microstructure. Through a structurally and mechanically compromised cortical compartment, skeletal effects of smoking become evident at the micron level, which partially explains the inconsistent results observed at the macro-level, and the poor clinical outcomes. Postmenopausal effects on bone may also be compounded by smoking, thereby, placing women having undergone menopause at a greater risk for fracture.