Does Smoking Make Bladder Leaks and Urgency Worse?
Bladder & Pelvic FloorArticleSmoking shows up on most lists of bladder irritants. In a Norwegian survey of 27,936 women, leaking was linked with smoking only above 20 cigarettes a day. A 2024 US survey of 1,720 women found current smokers had 78% higher risk of moderate urgency, while former smokers had no extra risk. No trial has yet tested whether quitting dries things up. Here is what the studies show.
Smoking turns up on almost every list of things that make bladders worse. Here is what the research measured.
What the surveys found
| Study | Who | Finding |
|---|---|---|
| Norway, 2003 | 27,936 women aged 20 and up1 | Leaking was linked with smoking only in women who smoked more than 20 cigarettes a day; severe leaking was weakly linked at any level1 |
| United States, 2024 | 1,720 women answering an online bladder survey2 | Current smokers had 23% higher risk of urgency, 78% higher risk of moderate urgency and 40% higher risk of urge leaks than never smokers2 |
In the US survey, former smokers had no extra risk, even after accounting for how much they’d smoked.2 Heavy lifetime smoking, 20 or more pack-years, went with more urgency.2
In the Norwegian data, body weight had a stronger link with leaking than smoking did, across every type of leak.1
What these studies can’t show
Both are snapshots, so they show what travels together, not what causes what.12 The 2015 Cochrane review of lifestyle changes for leaks found no randomized trials of quitting smoking at all.3 The US authors called for studies to test whether quitting can treat urgency.2
What it means for you
- If you smoke and have urgency, the US finding that former smokers looked like never smokers is a hopeful sign, though not yet proof.2
- A chronic smoker’s cough also strains the pelvic floor with every cough. See why you leak when you cough.
- Weight loss has trial evidence for leaks: 76% of women in one weight-loss program reported improvement, versus 54% without it.3 See weight loss and bladder leaks.
- Blood in your urine matters more if you smoke or used to. See blood in urine after 50.
Try: “I smoke about a pack a day and I’ve been getting sudden urges to pee. Could the smoking be part of it, and what help is there for quitting?”
Laugh, Sneeze, Jump covers this in Chapter 8, “The Bedroom Chapter,” in a section called “The Levers Outside the Bladder.” Its Three-Day Read sorts your leaks into effort and urge, which tells you which levers, from weight to smoking to bladder training, are most likely to matter for you. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Blood in your urine needs prompt assessment, especially if you smoke or used to. See a clinician for burning, fever or back pain with urinary symptoms. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- BJOG, Norwegian EPINCONT study (abstract via PubMed), 2003Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study (opens in a new tab)abcd
- Neurourology and Urodynamics (abstract via PubMed), 2024Association of Smoking Status and Pack Year History With Urinary Urgency Symptoms (opens in a new tab)abcdefg
- Cochrane Database of Systematic Reviews (abstract via PubMed), 2015Lifestyle interventions for the treatment of urinary incontinence in adults (opens in a new tab)ab
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