Smoking is a common habit among men in both urban and rural India. Sadly, there is also a significant rise in number of women smokers, in last few decades. We all know that smoking has a significant cost burden on ones finances, health and relationships. It is recognised 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 Distress, Cancer & Cardiac illness is well-established and relatively widely understood, a similar level of knowledge is yet to be demonstrated regarding its link with 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 risk of Bladder Cancer amongst smokers is 43% and 26% in men and women, respectively. Understand that the Nicotine is excreted out of our system through urine. If you smoke even few cigarettes a day, your 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 amongst smokers. Hypertension caused by smoking may also play a role in adding to this risk
• KIDNEY STONES:The risk of stone formation and its recurrence is higher if you continue to smoke
• ERECTILE DYSFUNCTION: Smokers suffer from Erectile Dysfunction as well as Premature Ejaculation! You will not be able to enjoy both sex and smoking, you will need to choose one!
• INFERTILITY: Couples where one 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 diseases.

Discontinuing smoking has been shown to have a positive impact on urological disease. Aside from being a primary preventative measure in selected urological malignancies, post-diagnosis, discontinuation of smoking is associated with:

• Reduced recurrence rates and Cancer-specific mortality for Bladder Cancers
• Higher survival rate post Nephrectomy (Kidney removal) and a lower 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 its consequences. Health education and providing pathways to kick the butt should be an important part of the treatment. The diagnosis of a malignancy has been identified as a ‘teachable moment’, to impart 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 also be adopted for urological conditions.

(Disclaimer: Writer Dr Pankaj Maheshwari is Chief of Urology, Fortis Hospital. The views expressed are a personal opinion.)

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