Does Nicotine Make Incontinence Worse? The Link Between Smoking & Bladder Control

Alcohol, caffeine, and spicy food, for some, pleasures, for some, avoided, for those with incontinence, they can be contributors. Another substance that falls into this category, is nicotine.

We are living in a time where the nicotine industry has seen a rapid rise and one that despite a rise in regulations, legislation and discourse does not show signs of stopping. Whether it be in the form of cigarettes, vapes, or absorption products, how nicotine is being consumed is becoming vaster by the day.

How does nicotine affect the bladder?

Is there a difference between smoking and vaping?

What happens to bladder health when you quit?

How Nicotine Impacts Bladder Function

Nicotine is a stimulant, it overstimulates the bladder, makes it more sensitive and creates a frequent urge to urinate, even though it’s not necessarily full, similar to consuming caffeine, nicotine can inflame the bladder. That’s the simplest way to put it.

There have been clinical studies uncovering smokers have higher rates of symptoms of overactive bladders. For example, one large study noted that both current and former smokers had significantly more urge incontinence compared to non-smokers.

Looking further into this, women smokers having urge incontinence is about 3x more common than those who’ve never smoked.

Why though?

Well, to get scientific with it. The stimulating effect of nicotine on the detrusor muscle (the bladder’s muscular wall), makes you feel like you need to urinate even when your bladder isn’t full.

When tobacco chemicals get into the bloodstream, they eventually concentrate in urine. When that urine sits in the bladder, it exposes the bladder lining to these irritants.

The result? Inflammation of the bladder wall, making it more sensitive and less flexible, lowering your bladder’s capacity over time giving you the urge to go at smaller volumes.

Smoking vs. Vaping: Is One Better for Bladder Health?

Probably the biggest reason the market has seen an influx in products is due to the fact we have become much more conscious of what we’re putting into our bodies, and people always want to find less dangerous alternatives.

Assumptions would lead you to believe that vaping is a safer alternative, which could be true due to the elimination of smoke, however, it still supplies a deliverance of nicotine, sometimes even more than a cigarette along with other chemicals.

For your bladder, this still spells trouble.

The nicotine in e-cigarette vapour can provoke the same bladder irritation and urges as nicotine from traditional cigarettes. Health experts warn that vapers should also watch for signs of urinary dysfunction, just like smokers.

Vaping liquids can contain not only nicotine but also compounds like formaldehyde, metals (nickel, arsenic, lead), and other toxins. Substances that once in your bloodstream and urine, have the potential to irritate the bladder lining.

Both these nicotine products differ though.

Cigarettes can cause smoke-induced coughs, something that vapes lack, as “Smoker's cough” is caused by tar and smoke irritating the lungs. That cough? Well, that cough can wreak havoc on bladder control.

In contrast, vaping doesn’t cause the same level of chronic cough, so it’s gentler on the bladder, right?

Doctors emphasise e-cigarettes are not a “bladder-friendly” alternative. Nicotine is at the end of the day, still nicotine. No matter how it is digested it can still irritate the bladder.

Summarising this all, neither smoking nor vaping is a bladder-friendly alternative.

All forms of tobacco and nicotine whether cigarettes, e-cigarettes, hookah, or chewing tobacco, have been flagged as contributors to urinary issues and should be avoided for better bladder health.

Chronic Coughing from Smoking and Stress Incontinence

We brushed on coughing. So let’s go a bit deeper.

Smoking doesn’t just affect the bladder internally, it also indirectly leads to incontinence through the strain of chronic coughing.

Long-term smokers are prone to develop a persistent cough, harmless? Each coughing fit puts sudden pressure on the pelvic floor and bladder.

As the months, and years go this repetitive cough can weaken pelvic floor muscles that support bladder control.

The result is stress incontinence.

How though? Abdominal pressure. Coughing, sneezing, laughing, and exercising, are all examples.

Essentially, every time a smoker coughs hard, it’s like a little assault on the pelvic support of the bladder. This could explain why smokers have higher rates of stress urinary incontinence.

The NHS states “If you smoke, you put yourself at risk of incontinence, because coughing puts strain on your pelvic floor muscles.”

The risk factor for stress incontinence is largely due to the cough mechanism. The American Urological Association even highlights smoking cessation as “critical in reducing chronic cough which results in pressure on the pelvic floor muscles.”

So far we’ve uncovered that smoking contributes to both major types of incontinence: OAB (via bladder irritation) and stress incontinence (via coughing and weakened support).

So what happens if we quit?

Nicotine Withdrawal: What Happens to Bladder Control When You Quit?

When you quit smoking, your body will see changes, some immediate, some gradual, some not always the same as others.

Many bladder specialists encourage smokers with incontinence to quit, because stopping smoking often improves urinary symptoms over time.

What can you expect from your bladder when you go through nicotine withdrawal?

Well, you can expect good news. Without ongoing nicotine irritation, the bladder begins to calm down.

Studies have seen that those who successfully quit had significant improvement in how often they needed to pee, compared to those who relapsed.

Another, noting quitting smoking can lead to fewer overactive bladder symptoms within weeks.

That said, immediate improvements aren’t guaranteed to just happen overnight.

The first few days? Remember, your body is adjusting. Suddenly stopping nicotine, means your system needs to rebalance.

Some people feel they urinate less frequently immediately after quitting, partly because nicotine is no longer pushing their bladder to contract, and partly because some ex-smokers cut out other triggers like coffee or alcohol at the same time.

Any anxiety or jitters during withdrawal could, for a few, cause a tense bladder, but these effects are usually short-term. Over time the trajectory is positive, and incontinence symptoms gradually improve after you quit.

Former smokers tend to have higher incontinence risk than never-smokers, likely due to lasting damage from years of smoking.  The sooner you quit, the better for your bladder. Remember, it’s never too late to take nicotine out of the picture.

A Healthier Bladder Going Forward

Look, the relationship between nicotine and incontinence is clear as you can see, but while nicotine can bully your bladder, this doesn’t mean you have to let it bully you.

The health benefits of quitting smoking are countless, and improved bladder function is yet another to add to the list.

You have the chance to regain some control.

Breaking the nicotine kick is not easy. Each smoke-free day, you’re not only healing your lungs and heart, but on top of that, you’re giving your bladder a break from constant irritation.

In time, you could find yourself with steadier bladder control, fewer mad dashes to the toilet, and a lower risk of leaks. And that is a victory worth striving for!

Bladder and bowel incontinence may be caused by conditions which can be treated medically. Please consult your physician for medical advice and guidance. All sources used in this article are cited below.