INTRODUCTION
Bladder cancer (BC) is the 9th most common cancer in the world with high mortality rates.1 It is more common in developed countries but more mortal in developing countries.2 Nearly 75% of the BC are diagnosed at the non-muscle invasive stage which are treated with local treatments. Nearly one-third of non-muscle invasive bladder cancers (NMIBC) become muscle invasive (MIBC) during the follow-up period.3Smoking, occupational carcinogen exposure, dietary factors, environmental carcinogens, socioeconomic factors and genetic factors are the main risk factors for BC in which smoking has a significant effect.4-6 Several carcinogens like aromatic amines and nitrosamines are found in tobacco and cause DNA damage that is responsible for BC formation.7,8
Smoking is a prevalent bad habit in worldwide. Several social programs aim to decrease the smoking rate but smoking habit does not decline in many countries.9 Not only for the formation of BC, smoking is also proposed to be a risk factor for recurrence and progression. For that reason, patients who are smokers at the time of diagnosis must stop smoking. One of the main responsibilities of the clinician is to inform their patients about the hazardous risks of smoking for their health. All clinicians recommend their patients to stop smoking as soon as they diagnose BC. On the other hand, the main question is; “does the patient understand and pay attention to this reality and do they really stop smoking?” Most of the studies reported the importance of cessation of smoking for the BC patients but there are limited data documenting the reality about the rate of cessation of smoking among BC patients.10,11
The primary aim of our study was to evaluate the behavior of BC patients in terms of cessation of smoking after the diagnosis. The secondary aim is to determine timing of patients to stop smoking after the diagnosis. The tertiary aim was to evaluate the effect of ongoing smoking on recurrence and progression of BC.