Updated 01 March 2019

Have a bladder issue and don't know why? It could be your smoking

The link between smoking and chronic diseases has been known for years. But did you know that urinary incontinence and other bladder conditions may also be tied to smoking?

Smoking cigarettes has a bad rap and is tied to many health problems, but did you know that it can also affect your bladder health?

Current and previous smokers may have an increased risk for urinary incontinence, especially stress urinary incontinence, which is the most common type.

Stress urinary incontinence literally refers to a type of stress placed on your bladder. It happens when there are episodes of increased intra-abdominal pressure on the bladder (when you cough and sneeze, for instance) and it is caused by a loss of bladder neck and urethral support.

What does smoking have to do with it?

The reason why cigarette smoking can be linked to urinary incontinence and other bladder problems is not exactly clear, says urogynaecologist Dr Sharon Knight. “Some explanations have been proposed, such as nicotine-induced bladder contractility and some other toxins that can be bladder irritants,” she said.

There are other factors that link smoking with an increased risk of incontinence, particularly stress incontinence:

A chronic cough caused by smoking could place more pressure on the abdomen and bladder, potentially leading to stress incontinence as it can damage the muscles of the pelvic floor.

Smoking is a risk factor for bladder cancer, which can present through urinary incontinence at first. According to research published in Reviews in Urology there is evidence that smoking may lead to bladder cancer as each puff of smoke exposes the body to some 60 different carcinogens, many of which are identifiable in urine specimens from smokers.

Interstitial cystitis, a chronic, painful bladder condition that causes a constant feeling of pressure in the bladder, an increase in frequency of urination and urge incontinence, can be aggravated by smoking. Even though a paper in Reviews in Urology states that there is no literature to date that links smoking directly to this specific condition, smoking cessation has been proposed in the treatment plan as smoking might aggravate symptoms and irritate the bladder even further.

Quit – there is no other solution

There are many other factors apart from smoking that can make you prone to urinary incontinence, but as smoking is now known to be a contributor to this condition, it’s a good idea to quit, not only to keep your bladder health intact, but also to stave off a host of other diseases.

It's no secret that smoking is tied to a host of cardiovascular and lung diseases, but now that researchers have connected urological problems with smoking, urologists should incorporate smoking cessation into their treatment plans.

Quitting smoking is easier said than done, but here are some tips:

  • Build a support group. Inform your friends and family about your decision and ask them to hold you accountable.
  • Incorporate nicotine replacement therapy, as it’s been proven that people are more successful at quitting when they make use of this method.
  • Don’t be discouraged if you break your cigarette fast – simply start again.
  • Get more exercise and eat a healthy, balanced diet. 

Image credit: iStock


Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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