Smoking Is Ravaging Your Appearance: Here’s The Proof

If you’re a smoker, you probably frequently wonder about how your habit could be affecting your appearance. Just how much older are all those ciggies making you look? This photographic study of identical twins with different smoking histories provides a chilling answer.

Premature ageing picture from Shutterstock

There is plenty of evidence that links smoking to premature ageing, but when it comes to individual patients, the cause can be tougher to determine. After all, appearances deteriorate at different rates depending on a wide range of factors, including genetics. So how much is actually linked to smoking and how much is hereditary?

In a bid to find out, researchers from University Hospitals in Cleveland compared the appearance of 79 identical twins participating in the Twins Days Festival in Twinsburg. Each pair of identical siblings contained a smoker and nonsmoker, or a twin who had smoked at least five years longer than his or her counterpart.

Each individual was then graded for wrinkles using the Lemperle Assessment Scale. To confirm that the twins’ environmental aging factors were properly controlled for, a Mann-Whitney test was performed on their sunscreen use, alcohol intake and perceived work stress.

Below are a handful of comparative results from the study:


“The twin on the right is a smoker, the twin on the left is a nonsmoker. Notice the difference in nasolabial creases.”


“Both twins are smokers. The twin on the right smoked for 14 years longer than his brother.”


“The twin on the left has smoked 17 years longer than the twin on the right. Note the difference in lower lid bags and upper and lower lip wrinkles.”


“”The twin on the left is a nonsmoker and the twin on the right smoked for 29 years. Notice the difference in periorbital ageing.”

As is plainly evident in the above photos, different smoking histories lead to specific components of facial aging; even in twins with identical genetic makeup.

“Smoking twins compared with their nonsmoking counterparts had worse scores for upper eyelid skin redundancy, lower lid bags, malar bags, nasolabial folds, upper lip wrinkles, lower lip vermillion wrinkles, and jowls,” the report explains.

“Lower lid hyperpigmentation in the smoking group fell just short of statistical significance. Transverse forehead wrinkles, glabellar wrinkles, crow’s feet, and lower lip lines accentuated by puckering did not have a statistically significant differences in scores.

“Among twins with greater than 5 years’ difference in smoking duration, twins who had smoked longer had worse scores for lower lid bags, malar bags, and lower lip vermillion wrinkles.”

In other words, smoking primarily affects the middle and lower thirds of the face and can cause noticeable differences in facial aging after just five years, even when allowing for natural ageing.

The researchers acknowledge that they were unable to control certain environmental factors in their study, particularly in the areas of fat distribution as well as subtle movement in mimetic facial muscles. We also think it’s odd that the study allowed women to wear makeup, which can drastically affect the appearance of age.

Nevertheless, if you’re looking for added motivation to quit, perhaps this is the kick up the butt you need.

See also: Where Is Smoking Banned In Australia? | Ask LH: How Can I Ask A Smoker To Move On? | Quitbuddy Is A Stop Smoking App

Facial Changes Caused by Smoking: A Comparison between Smoking and Nonsmoking Identical Twins [Journal of the American Society of Plastic Surgeons]


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