Introduction: Bladder cancer is known to be strongly associated with smoking tobacco products. Urologists thus have an imperative role in providing smoking cessation counseling to patients to prevent the development of bladder cancer, recurrence, and other morbidities associated with smoking. Asymptomatic hematuria is often a presenting clinical symptom that warrants further investigation. It also provides an opportunity to discuss patient’s smoking habits. This study aims to determine if smokers who have an episode of asymptomatic hematuria are more likely to quit smoking when urologists provide formal smoking cessation counseling.
Methods: We completed a retrospective chart review of patients who presented for asymptomatic hematuria at our institution between 01/2017 and 03/2020. A total of 435 patients were identified, 134 of which were active smokers at the time of presentation. We recorded smoking status at initial presentation, documentation of smoking cessation counseling, and smoking status at 1 year follow up. Fischer’s exact test was used for analysis. Statistical significance was set by convention at p <0.05.
Results: The percentage of patients presenting with an episode of asymptomatic hematuria that quit or cut back at 1 year follow up was 24.2% (95% CI: 13.8%, 34.7%). In assessing the effect of formal smoking cessation counseling, 33.3% of patients with documented smoking cessation counseling quit or cut back at 1 year as compared to 22.8% of patients with no documented counseling. However, these findings were not statistically significant (p = 0.676). Of note, smoking cessation counseling was documented in 19 active smokers (14.0%) and 68 active smokers (51.0%) did not receive follow up at 1 year.
Conclusions: Smoking cessation remains a difficult endeavor for both patients and Urologists. Formal counseling did not significantly contribute to quitting rates among patients and rates of documented counseling from providers were unsubstantial. Urologists should utilize hematuria work-up visits to provide smoking cessation counseling.