Research suggests smoking may not increase the risk of developing prostate cancer. However, smoking may worsen the outlook for a person who develops prostate cancer.

Most research into smoking and prostate cancer focuses on tobacco products, rather than e-cigarettes. Further research is necessary to fully understand the link between smoking and prostate cancer.

This article examines the current research, other prostate cancer risk factors, and whether prevention is possible.

An adult make smoking a cigarette in a park.-1Share on Pinterest
FluxFactory/Getty Images

Research in a 2023 systematic review suggests smoking does not cause or increase the risk of prostate cancer.

Recent studies, including those in another 2023 systematic review, suggest a reduced risk of prostate cancer in people who smoke. The researchers also did not associate former smoking with an increased risk of prostate cancer.

However, it is important to note that the authors of the review suggest the reason for these findings may be that smokers have a low attendance rate of prostate cancer screenings.

Another reason may be that smoking can lead to aggressive health conditions, including other cancers and heart and lung diseases, which may affect mortality before a prostate cancer diagnosis. However, these theories require further research.

In people with prostate cancer, people who smoke at the time of diagnosis may have more aggressive cancer with an increased risk of:

  • cancer spreading to distant areas
  • biochemical recurrence, which is an increase of proteins called prostate specific antigens that may indicate the cancer has returned after treatment
  • cancer-specific and overall mortality

Risk of death from prostate cancer

A 2023 systematic review suggests smoking increases the risk of death from prostate cancer in those with the condition.

The research found that people who smoked at the time of receiving a prostate cancer diagnosis had a 42% increased risk of death compared with people who did not smoke.

A risk factor does not cause a disease, but can increase the chance of developing it.

According to a 2023 review, cigarettes contain at least 70 potentially cancer-causing substances, including polycyclic aromatic hydrocarbons (PAHs) and cadmium.

The review’s authors write that:

  • changes to the genes that help metabolize and detoxify PAH from the body may increase the risk of prostate cancer
  • cadmium affects and mimics the activity of androgens, which are sex hormones
  • an increased level of androgens links to an increased risk of prostate cancer

They highlight research that suggests smoking may also increase inflammation of the prostate, which may contribute to the development or progression of prostate cancer.

Although the review found that people who smoke appear to have a lower risk of prostate cancer, the authors suggest this may be due to lower rates of prostate cancer testing among people who smoke. Smoking any tobacco products, such as cigars, may also link to a less positive outlook for people with prostate cancer.

According to a 2018 review, tobacco smoking at the time of prostate cancer diagnosis may significantly increase the risk of recurrence, cancer-specific mortality, and overall mortality.

Smokeless tobacco products may also worsen the outlook for a person with prostate cancer. A 2023 review notes research that found people who never smoked but used Swedish snus had a higher overall mortality risk and a higher risk of dying from prostate cancer than people who never used tobacco.

Nicotine may link to chronic prostate inflammation, which may play a part in the negative effect smoking can have on the outlook for a person with prostate cancer.

A 2022 animal study examined the effects of exposure to smoking compared with e-cigarette exposure in rats. The researchers found of both types of cigarettes had similar effects on genes that play a role in prostate cancer development.

The researchers suggest that vaping is not a safer alternative to cigarette smoking. However, further studies are necessary to understand the effects of vaping on prostate cancer risk in humans.

Risk factors for prostate cancer include:

  • Older age: There is an increased risk of prostate cancer over the age of 50.
  • Race and ethnicity: Prostate cancer is more common in African Americans and people from the Caribbean with African ancestry compared with people with other racial and ethnic backgrounds.
  • Genetics: Prostate cancer can run in families, so there may be genetic risk factors. Certain inherited genetic mutations, including Lynch syndrome, can increase the risk of prostate cancer.

Other potential risk factors require further research but may include:

  • Diet: A high intake of dairy products and calcium may increase the risk of prostate cancer.
  • Obesity: Some research suggests obesity may increase the risk of more aggressive or advanced prostate cancer, with an increased risk of death. Research has not found a link between obesity and overall prostate cancer risk.
  • Chemical exposure: Exposure to certain chemicals, including arsenic and Agent Orange, may increase the risk of prostate cancer. Firefighters are more likely to experience exposure to chemicals that may increase prostate cancer risk than people with other occupations.
  • Prostate inflammation: Inflammation of the prostate gland may increase the risk of prostate cancer. Inflammation is common in cancerous prostate tissue samples.
  • Vasectomy: Some research suggests having a vasectomy may slightly increase prostate cancer risk, while other research suggests no increased risk.

The link between smoking and prostate cancer risk is unclear.

However, smoking can increase the risk of many other cancers. Experts recommend people who smoke do their best to quit to support their overall health.

The following steps may also help reduce the risk of prostate cancer:

  • eating a balanced diet, with plenty of vegetables, fruits, and whole grains, if possible
  • limiting consumption of processed foods, red meat, and sugary drinks
  • avoiding excess calcium and limiting calcium supplements
  • maintaining a moderate weight for the person’s body type
  • being as physically active as possible

Prostate cancer may not cause any symptoms in the early stages.

If it does, symptoms can include:

People should contact a doctor if they have any symptoms of prostate cancer. Detecting the condition at an early stage may mean it is easier to treat.

If people smoke, a doctor may also help provide support and a plan for quitting.

Cancer resources

To discover more evidence-based information and resources for cancer, visit our dedicated hub.

Does quitting smoking help the prostate?

Quitting smoking may help reduce inflammation in people with an enlarged prostate.

Smoking may increase the risk of prostate cancer recurrence and death from prostate cancer. Further research is necessary to know if quitting smoking can help reduce these risks.

Can smoking inflame the prostate?

Smoking may contribute to inflammation of the prostate, which may play a role in the development and progression of prostate cancer. Nicotine may also lead to chronic prostate inflammation.

Can smoking and drinking cause prostate cancer?

Smoking may not directly cause prostate cancer. However, it may worsen the outlook for a person with prostate cancer.

It is not clear if alcohol can cause prostate cancer. A high intake of any type of alcoholic drink may increase the risk of prostate cancer. Alcohol may also increase the rate of growth and progression of prostate cancer.

There is conflicting research on smoking and prostate cancer. Many studies suggest smoking does not increase the risk of prostate cancer, but it may significantly worsen the outlook for a person with prostate cancer.

Smoking may increase the risk of more aggressive cancer, cancer recurrence, and death from prostate cancer.

People can talk with a doctor about risk factors for prostate cancer and help for quitting smoking.