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Bladder Health Month and the Great American Smokeout - November 21st

In honor of both, today we are going to cover the damage that smoking nicotine products and tobacco use can do on the bladder.

Doctors have known for decades that smoking affects lung and heart health, greatly increasing risk of both lung cancer and heart disease. In recent research, they have been finding that smoking increases risk to various urologic diseases as well.

Bladder Cancer

Cigarette smoking triples the risk for bladder cancer when compared with the risk in nonsmokers, about 50% of bladder cancer in men and 20% in women can be attributable to smoking (Freedman, 2011). Cigarette smoke contains about 60 different carcinogens, and many of these are identifiable in the urine of smokers (Manatonski, 1981). Cigarette smoking is one of the largest risk factors we can control to prevent the development of bladder cancer in men and women. 

Prostate Cancer


Although the cause of prostate cancer is not clear, some researchers believe it may be due to various factors including genetics, diet, inflammation, infectious agents, hormonal imbalance, or exposure to toxins like cigarette smoke (Dwivedi, 2012). A 2012 study by Dwivedi found that smoking increased inflammation in the prostate, increasing cancer risk and also making the disease more aggressive. The Johns Hopkins Medical center published in 2003 that cigarette smoking causes oxidative damage that could make prostate cancer worse for men who smoke vs. non smokers.

Kidney Cancer

Smoking tobacco is a risk in the development of cancer in the kidneys and ureters. A 2011 study in the UK estimated that 29% of cases in men and 15% in women were associated with or caused by smoking (Parkin, 2011). Kidney cancer risk also increases with the number of cigarettes you smoke a day as well as the amount of time you’ve been smoking. The risk of kidney cancer is 60% to 100% higher in the patients smoking 20 or more cigarettes daily compared with nonsmokers (Parkin, 2011). Fortunately in the same study, they found that quitting smoking, especially quitting for over 10 years had a measurable decrease in cancer risk.

Erectile Dysfunction


Smoking negatively affects your body’s vascular system and is tied to erectile dysfunction, since the penis relies on blood flow to reach full erection. The Olmsted County Study of Urinary Symptoms (Jacobsen, 1993) found that smokers had an increased incidence of erectile dysfunction vs nonsmokers, especially for men between the ages 40 and 79.

Kidney Stones 


A 2013 study by Tamadon showed that smoking increased the risk of stone formation; 26.5% of the patients with stones were cigarette smokers, and only 14.9% in the control group were smokers. This shows a possible link between smoking and risk of kidney stone formation.

Incontinence

The nicotine in tobacco has been shown to irritate the muscle that controls the bladder (Wyman, Burgio, & Newman, 2009). Smokers are also likely to have a chronic cough which can create more pressure on the bladder and pelvic floor.

Infertility

Studies have shown smoking negatively affecting fertility in both men and women.
Soares (2008) found that compounds in tobacco disrupt the maturation of ovarian follicles as well as the uterine receptiveness to implantation. During pregnancy, smoking has been linked fetal growth retardation, fetal death, premature delivery, lactation problems, and long-term effects on the child (Mobley, 2015).


Cigarette smoking also reduces sperm production, increases oxidative stress, and DNA damage. Sperm from smokers have less ability to fertilize egg cells and embryos display lower implantation rates. It has also been found that exposure to tobacco compounds in the womb can lead to reduced sperm count in adult life (Soares, 2008).

Interstitial Cystitis

Tobacco can aggravate symptoms of Interstitial cystitis (IC) which includes painful bladder, increased urgency and frequency of urination, and pelvic pain. An Austrian study of 981 subjects, found that smokers with IC had the highest prevalence of more severe symptoms. Both the National Kidney Foundation and the International Urogynecological Association recommend quitting smoking for those with IC.

How to Stop Smoking

For more information on smoking cessation check out the following online resource in addition to consulting with your doctor:

Resources


Mobley, D., & Baum, N. (2015). Smoking: Its Impact on Urologic Health. Reviews in urology17(4), 220–225.

Manatonski GM, Elliott EA. Bladder cancer epidemiology. Epidemiol Rev. 1981;3:203–229. [PubMed] [Google Scholar]

Freedman ND, Silverman DT, Hollenbeck AR, et al. Association between smoking and risk of bladder cancer among men and women. JAMA. 2011;306:737–745. [PMC free article] [PubMed] [Google Scholar]

 Dwivedi S, Goel A, Mandhani A, et al. Tobacco exposure may enhance inflammation in prostate cancer patients: an exploratory study in north Indian population. Toxicol Int. 2012;19:310–318. [PMC free article] [PubMed] [Google Scholar]

  1. Prostate cancer is worse in men who smoke. Prostate Cancer Update. [Accessed October 21, 2015]. The James Buchanan Brady Urological Institute website. http://urology.jhu.edu/newsletter/prostate_cancer612.php.
  1. Parkin DM. 2. Tobacco-attributable cancer burden in the UK in 2010. Br J Cancer. 2011;195(suppl 2):S6–S13. [PMC free article] [PubMed] [Google Scholar]

 Jacobsen SJ, Guess HA, Panser L, et al. A populationbased study of health-care seeking behavior for treatment of urinary symptoms. The Olmsted County Study of Urinary Symptoms and Health Status Among Men. Arch Fam Med. 1993;2:729–735. [PubMed] [Google Scholar]

 Tamadon MR, Nassaii M, Ghorbani R. Cigarette smoking and nephrolithiasis in adult individuals. Nephrourol Mon. 2013;5:702–705. [PMC free article] [PubMed] [Google Scholar]

Wyman, J. F., Burgio, K. L., & Newman, D. K. (2009). Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. International journal of clinical practice63(8), 1177–1191. doi:10.1111/j.1742-1241.2009.02078.x

Soares, S. R., & Melo, M. A. (2008). Cigarette smoking and reproductive function. Current Opinion in Obstetrics and Gynecology, 20(3), 281–291. doi:10.1097/gco.0b013e3282fc9c1e 

International Urogynecological Association., authors Interstitial Cystitis & Painful Bladder Syndrome: A Guide for Women. Washington, DC: International Urogynecoligal Association; 2011. []

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