Can smoking make your gout worse? Gout is a painful type of arthritis caused by uric acid crystals building up in the joints, often leading to sudden, intense flare-ups. Most people know that certain foods and alcohol consumption can trigger gout, but fewer realize that nicotine from cigarette smoking and other products may also increase the risk or make symptoms more severe.

Cigarette smoke may contribute to inflammation and impaired kidney function, both of which are linked to higher uric acid levels and a greater risk of gout attacks. This article explains how nicotine may influence gout risk and offers practical tips for managing symptoms, especially if you're working on quitting smoking.

Gout can be unpredictable, but it often follows patterns tied to lifestyle choices, medical conditions, and environmental exposures. Recognizing these risk factors can help lower your risk of gout and reduce painful flare-ups.

Gout is a type of arthritis that happens when uric acid builds up in the blood and forms sharp crystals in the joints. These crystals cause sudden pain, swelling, and redness, often in the big toe, ankles, or knees. Less commonly, other joints may also be affected. The attacks can be intense and may last for several days, especially in people with elevated serum uric acid levels.

Many triggers can lead to gout, especially when they raise uric acid levels in the blood or slow down the body’s ability to remove it. Research from the National Health and Nutrition Examination Survey and other prospective cohort studies shows that both lifestyle and medical factors play a role.

• Eating high-purine foods like red meat, organ meats, and certain seafood

• Alcohol consumption, especially beer and spirits, which increases serum urate levels

• Dehydration, which reduces kidney function and raises serum uric acid levels

• Taking medications  such as diuretics or low-dose aspirin

• Living with chronic kidney disease, which limits urate excretion

• Having other chronic diseases like coronary heart disease or rheumatoid arthritis

• Cigarette smoking  may increase systemic inflammation and affect uric acid metabolism

• High body mass index, which is linked to higher uric acid levels

• Genetic background or a family history of gout, as shown in statistical analysis from large health studies

Some studies, including the Singapore Chinese Health Study and analyses from the Korea National Health and Nutrition Examination Survey, suggest a potential association between smoking and an increased risk of developing gout, particularly among current smokers. However, more research is needed to establish a definitive link.

Nicotine affects several systems in the body that may increase the risk of gout, especially in people with chronic diseases like kidney disease or cardiovascular disease. Research from prospective cohort studies has helped identify how nicotine may influence key risk factors related to uric acid buildup.

Nicotine can temporarily increase heart rate and blood pressure, depending on the dose and how it is used. It also increases systemic inflammation and produces reactive oxygen species, harmful free radicals linked to tissue damage. These effects contribute to the deterioration of blood vessels and the body’s ability to repair itself, which may interfere with disease control in gout and other conditions.

While nicotine doesn't directly cause gout, it affects the body in ways that can make symptoms worse. A person’s smoking status, particularly among current smokers, has been tied to higher serum uric acid levels and reduced ability to eliminate uric acid through the kidneys. This can lead to elevated serum urate levels, increasing the risk of developing gout and more frequent flares.

Research, including the Singapore Chinese Health Study and data from the Korea National Health and Nutrition Examination Survey, has observed associations between cigarette smoking and the incidence of gout. However, these findings do not confirm a direct cause-and-effect relationship.

Statistical analysis from these surveys showed that the odds ratio for gout was higher in cigarette smokers compared to nonsmokers and those who are ex-smokers. This suggests a potential link worth further investigation.

The connection between smoking and gout may be explained by how smoking affects serum uric acid levels, impairs kidney function, and interacts with other lifestyle factors like long-term alcohol consumption, especially when these combined concentrations are present.

The effects of nicotine go beyond just cigarettes. Cigarette smoke, e-cigarettes, and other nicotine products can interfere with the body’s ability to manage uric acid levels and reduce systemic inflammation, both of which are critical for gout control. Research from national health and nutrition surveys highlights the connection between nicotine exposure and gout flare-ups.

Smoking doesn't just harm the lungs—it also fuels widespread inflammation that can worsen joint conditions like gout. These inflammatory changes are often more severe in individuals with existing rheumatoid arthritis or other chronic joint problems.

• Increases systemic inflammation, which can trigger gout attacks

• Produces free radicals, leading to tissue damage and slower healing

• Weakens the immune system, making it harder to control inflammatory diseases

• Raises levels of reactive oxygen species, which worsens joint pain

• Amplifies symptoms  in people with rheumatoid arthritis and other joint issues

• Reduces blood flow, delaying recovery from inflammation-driven flare-ups

When the kidneys can't filter out uric acid properly, it builds up in the blood, increasing the risk of gout. Studies, including those from Environmental Research and Public Health, show that cigarette smoking places additional stress on the kidneys.

• Reduces the kidneys' ability to remove uric acid, raising serum uric acid levels

• Increases the risk of chronic kidney disease, a major risk factor for gout

• Raises serum urate concentrations, which can trigger joint crystal formation

• Worsens kidney damage in people with high blood pressure or coronary heart disease

• Disrupts urate excretion, especially in people with high body mass index

• Elevates the risk of gout when combined with other lifestyle factors like alcohol consumption

Nicotine patches, gums, and e-cigarettes may seem safer than smoking, but they still pose risks for gout sufferers. Some studies suggest that nicotine exposure, regardless of the source, may influence inflammation and uric acid levels, though more research is needed on alternatives like patches and e-cigarettes.

• Continue to deliver nicotine, which may affect serum urate levels and circulation

• Can raise systolic blood pressure and delay uric acid removal

• Linked to inflammation in current smokers and those who have recently quit smoking

• May still affect serum uric acid measured, contributing to flares

• Could limit the benefits of smoking cessation if used long-term without reducing nicotine intake

• Associated with a higher odds ratio for incident gout in some studies

Quitting smoking while managing gout can be challenging, especially for current or former smokers. But with the right plan and support, it’s possible to reduce inflammation, manage flares, and protect long-term joint health. Following guidance rooted in preventive medicine and insights from internal medicine research can lead to real improvement.

Nicotine's effects on inflammation and kidney function are complex and poorly understood. While some research suggests it may have anti-inflammatory properties, other studies indicate it could contribute to inflammation and affect kidney health, which are relevant to gout development.

• Lowers  systemic inflammation, easing joint pain and swelling

• Improves circulation, helping the body clear uric acid more effectively

• Supports kidney health, reducing serum urate buildup

• Reduces  serum uric acid concentrations, which can decrease flare frequency

• Lowers the risk of cardiovascular disease, a common issue in gout patients

• Helps the body respond better  to urate-lowering therapy and other treatments

• Minimizes damage from free radicals  produced by smoking

These outcomes are not limited to heavy smokers; lean smokers and those with mild smoking status also benefit. Some research suggests that reducing nicotine exposure may support improvements in conditions related to inflammation, though more studies are needed to confirm the effects on gout symptoms specifically.

Building a strategy tailored to your needs increases the odds of success. Tools like counseling and medical health check-ups are proven methods for risk reduction.

• Set a quit date and create a plan with support from a healthcare provider

• Ask about nicotine replacement therapies like patches or gum

• Schedule regular health and nutrition examination appointments

• Use tools like mobile apps or counseling to stay on track

• Identify and avoid triggers that lead to smoking habits or relapse

• Track your improvements, including fewer gout flares and better energy levels

Nicotine withdrawal can lead to stress and physical changes that may affect uric acid levels and joint sensitivity. Staying committed to healthy habits helps keep your gout under control while you adjust.

• Stay hydrated to support kidney disease management and uric acid removal.

• Eat a low-purine diet and reduce alcohol intake to prevent flare-ups.

• Get light physical activity to improve circulation and reduce stiffness.

• Practice deep breathing and other stress-reduction techniques to calm inflammation.

• Monitor your serum uric acid level regularly during withdrawal for early warning signs of flares.

These steps not only support disease control but also create a foundation for long-term health improvement and sustained risk reduction.

Click here to learn more about Alerna's Uric Acid Support Supplements to enhance your joint health and overall well-being!

Nicotine may not directly cause gout, but it can raise the risk of flare-ups by increasing inflammation, harming kidney function, and raising uric acid levels in the blood.

Cigarette smoking and other nicotine products interfere with key processes that help the body control gout. This impact is especially strong in people with chronic diseases like kidney disease and diabetes mellitus, where the body already struggles to manage uric acid.

Quitting smoking may help reduce inflammation and improve overall health, which could support gout management. Over time, this may lead to fewer gout attacks and better overall well-being.

If you have gout and use nicotine, taking steps to quit can make a real difference in managing pain and protecting your joints long-term.

The information provided in this article is for educational and informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider before starting any new dietary supplement, especially if you are pregnant, nursing, have a medical condition, or are taking other medications. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

1. Jang, Y. S., Nerobkova, N., Yun, I., Kim, H., & Park, E. C. (2023). Association between smoking behavior and serum uric acid among the adults: Findings from a national cross-sectional study. PloS one, 18(5), e0285080. https://doi.org/10.1371/journal.pone.0285080

2. Jee, Y., Jeon, C., Sull, J. W., Go, E., & Cho, S. K. (2018). Association between smoking and gout: a meta-analysis. Clinical rheumatology, 37(7), 1895–1902. https://doi.org/10.1007/s10067-018-4118-y

3. Nagasawa, Y., Yamamoto, R., Rakugi, H., & Isaka, Y. (2012). Cigarette smoking and chronic kidney diseases. Hypertension research: official journal of the Japanese Society of Hypertension, 35(3), 261–265. https://doi.org/10.1038/hr.2011.205

4. Tian, X., Zeng, G., & Wei, J. (2025). Systemic inflammation response index association with gout in hyperuricemic adults: NHANES 2007-2018. Frontiers in medicine, 11, 1490655. https://doi.org/10.3389/fmed.2024.1490655