Cigarette smoking, smoking cessation, and overactive bladder (OAB): a cross-sectional research of NHANES 2011 to 2018

Overactive bladder (OAB) is a prevalent lower urinary tract syndrome (LUTS) that adversely affects quality of life. Despite its increasing prevalence, particularly among the aging population, the pathophysiological mechanisms of OAB remain unelucidated. Cigarette smoking has been implicated in exacerbating certain LUTS. However, the relationship between smoking status and OAB, especially in terms of smoking cessation, remains underexplored. This cross-sectional study was conducted using data from National Health and Nutrition Examination Survey (NHANES) spanning 2011–2018, encompassing 16,789 participants aged 20 years and older. We investigated the associations of cigarette smoking and smoking cessation with OAB. Weighted logistic regression models were employed to estimate the odds ratios (ORs) for OAB and Overactive Bladder Symptom Score (OABSS) scores, adjusted for relevant sociodemographic, lifestyle and health risk factors. The analysis indicated that current smokers exhibited a higher risk of OAB (OR = 1.24; 95% CI: 1.04–1.47, P = 0.018) and an increased OABSS score (OR = 1.17, 95% CI: 1.05–1.31, P = 0.006) compared to never smokers. Furthermore, a dose-response relationship was observed between daily cigarette consumption and OAB risk, with heavy smokers demonstrating a significantly increased risk (OR = 1.95, 95% CI: 1.23–3.10, P = 0.006). Ex-smokers, did not significantly elevate the risk compared to never smokers (OR = 1.03,95% CI: 0.82–1.28, P = 0.808), but were significantly associated with a higher OABSS score among who without OAB (OR = 1.14, 95% CI: 1.02–1.28, P = 0.024). The study revealed that cigarette smoking was associated with a higher risk of OAB and a greater OAB-related symptom burden. Although the differences were not statistically significant, ex-smokers tended to show lower OAB risk than current smokers but still reported more severe symptoms than never smokers. These findings suggest that smoking history, including both current and past smoking, is relevant for the prevention and management of OAB and support the promotion of smoking cessation in this context. More rigorous prospective cohort studies are warranted to further clarify these associations and their potential causal pathways.