31st May Antismoking day | Dr. Pankaj Maheshwari

Smoking and Kidney Diseases

Smoking is a common habit among men in both urban and rural India. Sadly, there is also a significant rise in women smokers in last few decades. We all know that smoking carries a significant burden of cost: financial, health and relationships. It is recognized as the most important preventable cause of ill health and disease. Remember: the best way to spoil your health is to smoke!!

Many smokers do so without knowledge of the myriad risks it poses to their health. While the link between smoking and respiratory and cardiac illness is well-established and relatively widely understood, a similar level of knowledge is yet to be demonstrated regarding the links between smoking and a number of urological conditions. You will be surprised to know that smoking is a causative factor for most benign and malignant kidney related diseases.

Let’s look at them now.

Bladder cancer: Smoking is thought to be the causal factor in up to 67% of bladder cancer diagnoses. The attributable risk of bladder cancer for smoking being 43 and 26% in men and women, respectively. Understand that the nicotine is excreted out of our system through the urine. If you smoke even few cigarettes a day, urine would always contain nicotine and other carcinogenic agents that can lead to bladder cancer.
Kidney cancer: 20% of renal cell carcinomas are linked to smoking.
Prostate cancer: Smoking may not directly cause prostate cancer but it increases prostate cancer-specific death rate.
Kidney failure: Chronic kidney disease is more common in smokers. Hypertension caused by smoking may also play a role in this.
Kidney stones: the risk of stone formation and the risk of recurrence is higher if you continue to smoke.
Erectile dysfunction: smokers suffer from ED as well as premature ejaculation. You will not be able to enjoy both sex and smoking, you will need to choose one!
Infertility: Couples in whom either or both partners smoke have a higher chance of subfertility. Even the children born to such couples are underweight and have a higher risk of lung issues.

Like many other pathologies, smoking cessation has been shown to have a positive impact on urological disease. Aside from being a primary preventative measure in selected urological malignancies, post diagnosis, smoking cessation is associated with reduced recurrence rates and cancer-specific mortality for bladder cancers. Similarly, in kidney cancers, smoking cessation is associated with a higher survival rate post nephrectomy and a lower overall mortality.

As a treating urologist it is important to take greater responsibility in this preventable health measure. A key step in implementing behavioral change such as smoking cessation is promoting awareness of the related health consequences.Smoking education and providing pathways to cessation should be an important part of treatment. The diagnosis of a malignancy has been identified as a ‘teachable moment’ with regard to conveying knowledge about the risk factors associated with that malignancy. The message goes wide and clear to the patient and his well-wishers. Graphic health warnings on cigarette packaging should be adopted relating to urological conditions.

Friends, ‘Acche din and acchiraat’ are possible only with pristine health; and smoking and health do not go together.