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Two new wrinkles for cigarette smokers.

Lung cancer, heart attack, stroke. For some people who seek out risky activities, the deadly dangers of smoking actually increase the cigarette's allure, research has shown. But two new reports focusing on certain nonlethal effects of smoking may provide even these daredevils with powerful incentives to kick the nicotine habit.

One study shows that women who smoke cigarettes may face an increased threat of developing urinary incontinence. The other confirms the link between smoking and premature wrinkling of the skin.

Researchers at the Medical College of Virginia in Richmond have gathered data suggesting that approximately one-third of all women suffering from urinary incontinence can blame this embarrassing problem on a current or past smoking habit. Richard C. Bump reported his team's preliminary data last week at the annual meeting of the American College of Obstetricians and Gynecologists, held in New Orleans.

Many physicians suspected that a smoker's hacking cough could contribute to the development of some types of incontinence.

However, says Thomas G. Stovall of the University of Tennessee in Memphis, "to my knowledge this is the first paper of its kind to address the independent contributing role of smoking in urinary incontinence."

The Virginia researchers studied 606 women aged 13 to 87 (with a mean age of 46) and uncovered a statistically significant relationship between smoking and all forms of urinary incontinence, including "stress" incontinence, in which abdominal pressure triggers the loss of small amounts of urine, and another type that involves large urine spills.

Of the 322 women suffering from incontinence, 35 percent reported a smoking habit. By contrast, only 24 percent of 284 women who showed no signs of bladder problems said they smoked cigarettes. Former smokers also were overrepresented among the incontinent subjects: 16 percent of the incontinent women reported a previous history of smoking, while only 8 percent of continent women said the used to smoke. Only 49 percent of the incontinent had never smoked, whereas 68 percent of the continent had never smoked.

According to the team's statistical analysis, smokers and former smokers run twice the risk of all types of incontinence compared with nonsmokers.

Although the mechanism by which smoking causes urinary incontinence remains unclear, Bump speculates that nicotine may cause the muscles controlling the bladder to contract, thereby leading to urine spills. Other cases may develop when violent coughing, caused by irritating cigarette smoke, weakens the muscles that keep the bladder's urethra closed, he says.

The Virginia study did not assess the risk of urinary incontinence among male smokers, but another report brings bad news for smokers of both genders. At the University of Utah Health Sciences Center in Salt Lake City, Donald P. Kadunce and his colleagues have found that men and women who smoke are more prone to facial wrinkling than their nonsmoking peers.

The Utah team studied 109 smokers and 23 people who had never smoked. To assess skin condition, the researchers photographed the participants and used a numerical score as an estimate of wrinkle severity. After controlling for sun exposure, age and sex, the investigators discovered that premature wrinkling increased with cigarette consumption and the duration of the smoking habit. Heavy smokers were nearly five times more likely to show excessive skin wrinkling than their nonsmoking counterparts, the authors report in the May 15 ANNALS OF INTERNAL MEDICINE.

Smokers with a penchant for sunbathing may face the greatest risk of facial furrows, given the researchers' finding that excessive sun exposure and smoking may work together to produce wrinkles.

The team speculates that smoking hastens wrinkling by damaging collagen, a fibrous protein found in skin. They add that eye irritation from smoke, especially in bright sunlight, could lead to squinting, which in turn could cause crow's feet.

Taken together, the two reports add substantially to the negatives associated with cigarettes. "For many smokers, particularly the young, evidence that smoking causes conditions like wrinkles, bad breath or yellow teeth is much more compelling than the evidence that smoking kills," says Thomas E. Kottke at the Mayo Clinic in Rochester, Minn., who wrote an editorial accompanying the Utah group's report.
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Title Annotation:premature wrinkling and urinary incontinence in women
Author:Fackelmann, Kathy A.
Publication:Science News
Date:May 18, 1991
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