Association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms in older American men: Findings from the third National Health and Nutrition Examination Survey

OBJECTIVES: To examine the association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms (LUTS) in older men. SUBJECTS AND METHODS: The study included 2797 men participating in the Third National Health and Nutrition Examination Survey (NHANES III), who were aged ≥60 years. During an interview, LUTS, smoking history, alcohol consumption and physical activity were assessed. Cases comprised men with at least three of the symptoms of nocturia, hesitancy, weak stream and incomplete emptying. Men who had had prostate surgery unrelated to cancer were not included as cases. Controls were men with no symptoms or surgery. We adjusted for age and race in logistic regression models and used sampling weights to account for selection probability. RESULTS: Current cigarette smokers had no higher odds of LUTS than 'never' smokers, but former heavy smokers (≥ 50 pack-years) had a higher odds of LUTS than never smokers (odds ratio 2.01; 95% confidence interval 1.04-3.89). Men who drank alcohol daily had a lower chance of LUTS than non-drinkers (0.59; 0.37-0.95; P trend, 0.07). All levels of moderate and vigorous activity were statistically significantly inversely associated with LUTS (P trend, 0.06), whereas men who reported no leisure-time physical activity had a greater odds of LUTS (2.06; 1.26-3.39). CONCLUSIONS: Moderate alcohol consumption and physical activity may be protective against LUTS. Current cigarette smoking was not consistently associated with the condition. The possible association in former smokers warrants further investigation.