Chronic gout sufferers understand the crippling pain and frustration all too well. While the dangers of smoking for lung and heart health are clear, its connection to the development of gout is less supported. This article explains nine distinct ways cigarette smoking increases the risk of gout. It offers often disregarded information on how quitting the habit can make a real difference for smokers battling the most painful form of arthritis.
How Does Smoking Cigarettes Increase Uric Acid and Gout Risk?
1. Acidifying Effects
According the American Lung Association, there are over 7000 chemicals in cigarette smoke. Harmful substances such as nitrous oxide, amonia, formaldehyde, and numerous other compounds quickly convert to acids in the body. This disrupts the body’s senstive pH balance, making it less alkaline. This change can affect how well uric acid dissolves and create an environement conducive to crystal formation at joints.
More so, the acidifying effects of smoking influences urine pH, which is critical in gout management. When urine is very acidic, less uric acid can be filtered out of the body, raising the likelihood of gout.
2. Impaired Kidney Function
Heavy metals (cadium, lead, mercury), enviromental contaminants (pesticides, herbacides) and nicotine, from cigarette smoke can damage kidney tissue and uric acid transporters. Nicotine, a vasoconstrictor, reduces blood flow to the kidneys, impacting their ability to efficiently filter and excrete wastes like uric acid.
Additionally, carbon monoxide can bind to hemoglobin, compromising oxygen delivery to the kidneys. The combined effects of these chemicals in a smoker’s body can create a complex and unpredictable interaction, further complicating health problems, including gout.
3. The Dehydration Factor
Smoking contributes to chronic dehydration, a crucial factor in gout management due to its direct impact on urate levels. Adequate hydration is essential for maintaining efficient uric acid elimination and minimizing the development of gout symptoms.
When you stay well-hydrated, uric acid remains dissolved and is efficiently eliminated by the kidneys. The lack of water increases uric acid concentration in the blood and hampers kidney function. Consequently, this may result in the accumulation of urate crytals within a joint.
The smoke that dries your mouth and throat is a mild factor for dehydration. The more significant factor is nicotine because of its diuretic properties. This means nicotine increases urine output and depletes the body’s fluid reserves.
4. The Metabolic Syndrome Connection
Cigarette smoking can influence the conditions of the metabolic syndrome: insulin resistance, obesity, dyslipidemia, and elevated blood pressure. Here is what research studies have determined about the connection of the metabolic syndrome and gout:
- Obesity raises inflammatory substances and insulin resistance, influencing uric acid levels.
- Abnormal (visceral) fat and cholesterol levels associated with the syndrome contribute to inflammation.
- High blood pressure and insulin resistance impacts kidney function in filtering out uric acid.
5. Poor Circulation – Vascular Dysfunction
This condition is directly linked to the metabolic syndrome, particularly with hypertension or high blood pressure. Smoking is a direct cause to atherosclerosis, a condition caused by plaque buildup in arteries. It narrows and hardens blood vessels, heightening the risk of cardiovascular disease. Furthermore, a 2020 research study found that uric acid promotes the development of atherosclerosis and inflammation.
Besides, damaging blood vessels, smoking poses a dual threat to the circulatory system by also thickening blood. This compromises the flow of oxygen and nutrients to inflamed joints and slowing recovery from gout attacks. More over poor circulation, or weakened blood flow, restricts the movement of uric acid away from joints. This, in turn, leads to a faster buildup, triggering intense gout pain.
6. Weakened Immune System
Heavy cigarette smoking weakens the immune system, impairing antibody production and making smokers more susceptible to infections that can raise uric acid levels. Additionally, smoking causes chronic low-grade inflammation throughout the body, including the joints, which increases the risk of gout.
7. Respiratory Impairment
The Centers of Control Diseases and Prevention (CDC) states lung function from smoking not only makes breathing difficult but also contributes to lower oxygen levels in the blood, negatively impacting many parts of your body, including joints.
Also, smoking weakens the airways’ protective cilia, increasing vulnerability to respiratory infections like bronchitis and pneumonia. These infections, in turn, can lead to dehydration and elevated uric acid levels; ideal conditions for gout symptoms.
8. Osteoporosis and Increased Joint Vulnerability
This condition is connected to poor circulation and a weakened immune system. This happens because smoking reduces calcium absorption and limits bone density, leading to conditions like osteoporosis. As a result, joints become more susceptible to damage and tophi during gout episodes, causing increased pain and longer recovery times.
9. Unhealthy Lifestyle Choices
Beyond the direct effects on uric acid, cigarette smoking influences unhealthy lifestyle choices that impacts the development of gout. For instance, the taste-bud-dulling effect of cigarette smoke can make individuals crave more flavorful but unhealthy food and drinks that are high in salt, purines or artificial sweeteners.
Furthermore, the notorious combination of nicotine and alcohol exacerbates the situation. Alcohol or beer, are major triggers due to their high purine content from yeast. They also dehydrate the body, leading to a higher urate concentration in the blood. Lastly, smoking worsens breathing and cardiovascular health, discouraging physical activity or excercise, another factor that increases the risk of gout.
For over 27 years, I was a heavy smoker with numerous attempts to quit, including two periods where I stopped for over a year. Breaking this habit and addiction seems improbable, but it’s not impossible. I exhausted every excuse or reason of procrastination not to quit. There’s no justification I haven’t used to break my many no-smoking streaks, just to start puffing on a Marlboro, Camel, or Dunhill again. Smoking becomes deeply ingrained and attached to your lifestyle, seeming necessary for all occasions; good or bad, sober or buzzed.
(Image: In the late 90’s you could save 5 Miles per pack to get Marlboro gear. I used this utility bag for many occassions. Nowadays, it’s for my dirty laundry! )
With that said, I can attest to all nine effects cigarette smoking has on increasing the risk of gout. Some of these effects are so obvious, yet we don’t feel they pose a threat because they are not evident in the present. However, they do compound over time in a detrimental and irreversible ways.
Although smoking does not directly cause of gout, its negative effects on overall health cannot be denied. The unhealthier you are, the weaker your body’s natural defense systems become against any illness.
Some smokers may never experience gout. For those smokers who are battlling it, to avoid the excruciating pain and debilitating episodes, should be added to your long list of reasons to quit. Learn this lesson now, or learn the hard way later, as I did. If you do, you’ll undoubtedly be healthier and likely more GOUTPROOF!“
- Harms of Cigarette Smoking and Health Benefits of Quitting – National Cancer Institute, 2017.
- How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General – Centers for Disease Control and Prevention, 2010.
- What’s In a Cigarette? – American Lung Association, 2023.
- The comparison of dyslipidemia and serum uric acid in patients with gout and asymptomatic hyperuricemia – BioMed Central Ltd, 2020
- Hyperuricemia and Its Associated Factors Among Adult Staff Members – of the Ethiopian Public Health Institute, Ethiopia
- Association between smoking behavior and serum uric acid among the adults: Findings from a national cross-sectional study – The Public Library of Science (PLOS), 2023
- Evidence for the immunosuppressive role of nicotine on human dendritic cell functions – National Institute of Health (NIH), 2003
- Health Effects of Cigarette Smoking – Centers for Disease Control and Prevention, 2021
- The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms – National Institute of Health, 2018