“…Indeed, the evidence regarding smoking and disease progression has been ambiguous [ 6 , 9 – 11 , 13 , 15 , 16 , 18 – 24 , 39 – 46 , 60 , 61 ]. The majority of studies among patients with NMIBC alone have reported no association between smoking and CSM [ 13 , 15 , 20 , 25 , 39 – 41 , 54 ] or ACM [ 11 , 25 , 26 , 39 , 40 ]. However, in studies with a mix of patients with NMIBC and MIBC, the evidence regarding an association between smoking and CSM [ 6 , 18 , 21 , 36 , 42 , 43 , 55 , 63 ] or ACM [ 18 , 21 , 36 , 38 , 42 , 43 , 56 – 59 , 63 ] has been mixed.…”