Tobacco smoking

Avoid

2 studies · 1 recommendation

Last updated: February 25, 2026

Avoid2 studies

Smoking doubles kidney cancer risk with persistent danger even after quitting

Two large prospective cohort studies totaling nearly 300,000 participants confirm tobacco smoking as a major kidney cancer risk factor. In the Nordic Twin Study (127,575 twins, 27-year median follow-up), current smokers faced a hazard ratio of 2.14 (95% CI: 1.95–2.34) for tobacco-related cancers including kidney cancer, while former smokers retained elevated risk at HR 1.31 (95% CI: 1.17–1.48). Genetically controlled analysis of 109 monozygotic twin pairs discordant for smoking yielded HR 1.85 (95% CI: 1.15–2.98), strengthening the causal inference by eliminating shared genetic confounding. The Norwegian Women and Cancer Study (~170,000 women) independently identified smoking avoidance as the strongest modifiable lifestyle factor for reducing kidney cancer incidence. Complete tobacco cessation is essential, though former smokers should remain aware of residual elevated risk.

Evidence

A healthy lifestyle index and cancer: Using a multifactor lifestyle exposure to estimate cancer incidence and survival among Norwegian women

Authors: Chen, Sairah Lai Fa

Published: August 17, 2023

In the Norwegian Women and Cancer Study prospective cohort of approximately 170,000 women, a higher HLI score was associated with lower kidney cancer risk. The HLI was constructed from five modifiable lifestyle components including smoking status. Smoking was noted as particularly strong in driving associations across multiple cancer types. Cox proportional hazard models and restricted cubic splines were used to estimate incidence associations. The study concluded that healthy lifestyle promotion, with smoking avoidance as a priority, should be facilitated throughout all adult ages.

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Cancer in twin pairs discordant for smoking : The Nordic Twin Study of Cancer

Authors: Adami, Hans-Olov, Clemmensen, Signe, Harris, Jennifer R., Hjelmborg, Jacob, Kaprio, Jaakko, Korhonen, Tellervo, Nordic Twin Study Canc NorTwinCan

Published: January 1, 2022

Among 127,575 Nordic twins with median 27-year follow-up, kidney cancer was one of eight tobacco-related cancer sites analyzed. Current smokers had HR 2.14 (95% CI: 1.95–2.34) for tobacco-related cancers overall compared to never smokers. Former smokers retained elevated risk at HR 1.31 (95% CI: 1.17–1.48). In 109 monozygotic twin pairs discordant for both smoking and cancer, the smoking twin had HR 1.85 (95% CI: 1.15–2.98) versus their never-smoking co-twin, providing genetically controlled evidence consistent with a causal relationship between smoking and these cancers.

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