We did a cross-sectional evaluation of the effect of heavy cigarette smoking on bone mass using single photon absorptiometry (SPA) of the radius in 35 smokers (24 women, 11 men) and 35 nonsmokers (24 women, 11 men). Individuals from the two groups were carefully matched for sex, age, weight, height, calcium intake, and, for women, menopausal history and estrogen use. We found no differences between smokers and nonsmokers at the middle or distal portion of the radius. This suggests that smoking has no direct effect on appendicular bone mass; however, it may still influence bone loss indirectly through effects on other factors such as age at menopause, body weight, diet, and possibly physical activity.