Smoking and skin health, what you need to know

The World Health Organization (WHO) states that 6 million people are killed every year from tobacco use.  600,000 of these deaths are caused by second-hand smoke.1

Although results from a statistical analysis from WHO showed that smoking decreased  in 2015, it continues to be an epidemic problem with over one billion smokers worldwide.2

How does smoking affect health?

Smoking is a major factor in negative health outcomes. It increases the risk of coronary heart disease and stroke by two to four times and of men and women developing lung cancer by twenty-five times.3

Smoking can also cause cancer in any part of the body. If nobody smoked, one out of every three cancer deaths would not happen.4

Other health issues that smoking causes include increased risk of cataracts, type two diabetes, tooth loss, rheumatoid arthritis and increased inflammation and a weakened immune system.4

The skin

Although many people may not consider it an organ, the skin is actually the largest organ of the body. It has many functions, some of which are protecting the body from microbes, regulating body temperature and producing vitamin D.

The skin is made up of three layers: the epidermis, the dermis, and the hypodermis. The epidermis is the outermost layer of skin. It is waterproof and creates skin tone. The dermis contains tough connective tissue, hair follicles, and sweat glands. The deepest layer, the hypodermis is made of fat and connective tissue.5

A timeline for ageing skin

During the natural process of ageing skin, there are increased dead skin cells when we reach our twenties. When we get to our thirties, there is decreased moisture from the dermis to the epidermis and fat cells start to shrink, which make the skin look dull and thin. In the forties, the production of collagen ceases and the skin loses its elasticity, which results in wrinkles and ageing lines. In our fifties, the skin is dry, easily bruised, damaged and broken.6

How smoking affects the skin

Although more research needs to be done, studies to date show that smoking increases the ageing of skin made apparent by wrinkling and local dermal ischemia (or the restriction of blood flow to the skin).

There are several studies that support the hypothesis that cigarette smoking contributes to skin wrinkling.

Skin autofluorescence (SAF) is a non-invasive marker of advanced glycation end products. In other words, a higher SAF is positively correlated with ageing. In a population-based cohort study looking at which lifestyle factors increased autofluorescence in 9,009 people, smoking was significantly associated with increased SAF. Other studies have found that smokers had a higher SAF than non-smokers. 7

While controlling for age, sex, sun exposure and skin pigmentation, Kadunce et al found that a smoking history of more than 0.9 packs per year was associated with a 3-fold increase in wrinkling. 8

In a cross-sectional study conducted with 227 people who had never smoked, 456 former smokers and 228 current smokers aged forty to sixty-nine years old, Enter et al. found that the estimated relative risk of moderate to severe wrinkling of current smokers as compared to people who had never smoked was statistically higher. 9

Helfrich et al were able to link the degree of ageing in nonfacial, photoprotected skin to a history of smoking. A correlation between the degree of ageing in photoprotected skin and the number of years of smoking, packs smoked per day and pack-years of smoking was found. In other words, the number of packs of cigarettes smoked per day was a major predictor of the degree of ageing in skin.10

In addition to smoking increasing wrinkling, smoking affects the cutaneous microvasculature of the skin. Nicotine increases vasopressin in the blood vessels, which in turn constricts blood vessels and causes ischemia. When this happens, reactive oxygen species (ROS) or free radicals are formed. Free radicals increase inflammation within the skin and therefore cause damage. This decreases blood flow to the skin causing less oxygen and vital nutrients like vitamin A to reach the skin.

The chemicals found in cigarette smoke also contribute to the breakdown of collagen and the depletion of vitamin C (which helps to form collagen). Collagen is an important protein structure that contributes to the strength and elasticity of the skin. If this is broken down by smoking, the skin sags and premature wrinkles are formed.

In addition to the above, a 1985 prospective study identified a clinical examining tool called “Smoker’s Face.”This was defined by wrinkles, gauntness and a gray appearance to the skin.11

The effects of smoking on identical twins

The difficulty of studies finding a correlation between smoking and the ageing of the skin is making sure that other factors, such as stress and exposure to the sun, are not responsible for the signs of ageing.

In 2007, an article was written documenting the difference in the appearance of the skin between identical twins. The twins spent the first two decades of their lives together. In later decades, the twins maintained the same type of job at the same latitude, resulting in well-matched levels of significant sun exposure. One twin never smoked and the other twin smoked roughly 52.5 packs of cigarettes per year.

This was a very interesting observational study as it provided the closest possible control of several key variables in skin ageing. The compelling observation found that the twin that smoked extensively throughout her life showed more severe skin ageing than the twin that never smoked.12

 Smoking causes more than skin ageing

Smoking is not only responsible for causing premature ageing of the skin.

Nutrition tips for protecting your skin

If you smoke, the best recommendation would be to stop altogether. According to the Centers for Disease Control and Prevention, quitting smoking can have health benefits at any age. These include reduced risk of cancer, heart disease and stroke, respiratory symptoms and infertility.19

If you have stopped smoking and are concerned about the negative effects on your skin, there a few things you can do nutritionally to help your skin get back its lustre.

  • Take an organic collagen supplement. Collagen production naturally decreases as we age and smoking destroys it. Therefore, the wise thing to do is to add back what has been lost thus far. You can also get collagen by making a home-made bone broth. Bone broth supplies the amino acids lysine and proline, the main proteins that make up collagen. They also help the liver to detoxify the body, removing any toxic remnants from previous tobacco smoking.
  • Boost the antioxidant status of your diet. Collagen cannot be formed without proper amounts of vitamin C. Make sure to eat three to five fruits and seven to nine servings of vegetables per day. An excellent way to get more nutrient-density in a smaller portion is to make a smoothie. Add antioxidant boosting fruits like berries and vegetables like kale or spinach.
  • Use coconut oil on your skin. Eating coconut oil is a great way to supply your body with medium chain triglycerides that can easily be converted into energy. In addition to this, however, coconut oil is a great antimicrobial and antifungal and can be applied directly to the skin to remove any toxic material leftover from smoking.

Smoking is a deleterious and dangerous habit that unfortunately damages and ages the skin. In addition to its many health consequences, smoking can increase wrinkles, damage cutaneous vasculature and increase the risk for chronic diseases like psoriasis and cancer. Do not wait for a crippling disease to find you. If you smoke, stop, and if you are a former smoker, enhance your daily intake of essential nutrients to replenish your body and protect your skin.


A consistent and regular skincare routine is essential to support your skin when it is either under the significant extrinsic stress of smoking or regenerating after you’ve ceased smoking. The 5 step simple skincare system designed by griffin+row is designed to replenish your skin, support and nurture your skin and through hydration and nourishment noticeably reduce the visible signs of ageing.

References and Sources:
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    7. Waateringe, Robert P., Sandra N. Slagter, Melanie M. Klauw, Jana V. Vliet-Ostaptchouk, Reindert Graaff, Andrew D. Paterson, Helen L. Lutgers, and Bruce HR Wolffenbuttel. “Lifestyle and clinical determinants of skin autofluorescence in a population-based cohort study.”European journal of clinical investigation 46, no. 5 (2016): 481-490. [Accessed February 13th, 2017]
    8. Kadunce  DPBurr  RGress  RKanner  RLyon  JLZone  JJ Cigarette smoking: risk factor for premature facial wrinkling. Ann Intern Med1991;114 (10) 840- 844 [Accessed February 14th, 2017]
    9. Ernster  VLGrady  DMiike  RBlack  DSelby  JKerlikowske  K Facial wrinkling in men and women, by smoking status. Am J Public Health1995;85 (1) 78- 82 [Accessed February 14th, 2017]
    10. Helfrich  YRYu  LOfori  A  et al.  Effect of smoking on ageing of photoprotected skin: evidence gathered using a new photonumeric scale. Arch Dermatol2007;143 (3) 397- 402published correction appears inArch Dermatol 2007;143 (5) 633 [Accessed February 14th, 2017]
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    13. Fortes C,Mastroeni S, Leffondre K et al. Relationship between smoking and the clinical severity of psoriasis. Arch Dermatol 2005; 141:1580–4. [Accessed February 14th, 2017]
    14. Armstrong, April W., C. T. Harskamp, J. S. Dhillon, and E. J. Armstrong. “Psoriasis and smoking: a systematic review and meta-“British Journal of Dermatology 170, no. 2 (2014): 304-314. [Accessed February 15th, 2017]
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    18. De Hertog, Sofie AE, Christianne AH Wensveen, Maarten T. Bastiaens, Christine J. Kielich, Marjo JP Berkhout, Rudi GJ Westendorp, Bert J. Vermeer, and Jan N. Bouwes Bavinck. “Relation between smoking and skin cancer.”Journal of Clinical Oncology 19, no. 1 (2001): 231-238. [Accessed February 15th, 2017]
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