Premature Wrinkling of Skin 

Tobacco use has been associated with premature aging and skin wrinkling.  Before undergoing cosmetic surgery for wrinkles one should suspend tobacco use.

Nyunova, et al. (2009) found that smoking accelerates aging by damaging the same protein which is damaged in Werner's syndrome, a genetic disorder which causes premature aging.   View Article 2009  Am J Respiratory and Critical Care Medicine    
This may help explain why smokers age and wrinkle and die 10 years sooner than non-smokers.

Yin L, Morita A, Tsuji T.  Alterations of extracellular matrix   
induced by tobacco smoke extract.  Arch Dermatol Res 2000 Apr;292(4):188-94
 
Aizen E, Gilhar A:  Smoking effect on skin wrinkling in the aged  
population.   Int J Dermatol. 2001 Jul;40(7):431-3.
 
Koh JS, Kang H, Choi SW, Kim HO:  Cigarette smoking             
associated with premature facial wrinkling: Image analysis of facial skin replicas.  Int J Dermatol. 2002 Jan;41(1):21-7.
 

Smoking Fires

If careless, cigarettes can cause life threatening fires.  To the right is a picture of a patient who was smoking a cigarette while using home oxygen to treat his chronic obstructive lung disease.  A fire and explosions ignited with extensive burns to the face and inside of the nose.  A video of the patient's nasal endoscopy can be viewed below. 

Cancer

Laryngeal (Voice Box) Cancer:  Over 90% of laryngeal cancers are caused by smoking.       

Lung Cancer:  Smoking causes 87% of all lung cancer cases.
 
  Click on Pictures to Enlarge
 

Oral and Esophageal Cancer:  The picture is from a 77 year old patient who had a 30 pack year history of smoking.  He quite smoking 26 years ago.  The picture  shows a large pyriform sinus cancer.  The pyriform sinus is located in the hypopharyngeal between the throat and the esophagus.  The cancer can be seen eating into the patient's voice box.

Chronic Hoarseness and Laryngeal Polyps  

Chronic smokers often develop a persistent hoarse voice with edema of the larynx and formation of vocal cord polyps.  Shown in the pictures below from left to right is a normal larynx, a larynx with massive vocal cord polyps (in a heavy smoker) and the same larynx after the polyps have been surgically removed.

        
  Click on Pictures to Enlarge
  

Smoking is a major factor in impotence ( View Article ).  It is also a turnoff to the opposite sex.  The following is a study taken in our local high-school.

Feldman A.H. et. al (Preventative Medicine 30(4):328-38, 2000) found that Cigarette smoking almost doubled the chances of developing moderate or complete erectile dysfunction.  Exposure to passive smoke also significantly increased the incidence of erectile dysfunction.

Question:  Do You Want Your Boy or Girl friend to Use Tobacco Products?
A total of  23 current tobacco users and 23 non-tobacco users were surveyed.  No respondent answered "YES".  There was no significant difference between tobacco users and non-users.

smoking has been implicated in the risk of diabetes, obesity ( View Article ) and mental retardation ( View Article ) in the newborn.  An increase incidence of cleft lip and palate has also been observed in maternal smokers
( View Article ).  Maternal smoking while pregnant also causes more miscarriages and creates low-birth weight babies (3). 

In the mother smoking during pregnancy can cause an increase chance of premature rupture of the membranes, abruptio placentae and placenta previa. (5)  In the child, maternal smoking during pregnancy increases the chances of premature delivery, still birth and sudden infant death syndrome (5).  View Article   Smoking during pregnancy is associated with an increase in neonatal admissions to the ICU and a corresponding increase in neonatal health care costs (6). View Article

In Kentucky, smoking mothers had a 66% higher chance of having a low-birth weight infant and twice the chance of having their child die of Sudden Infant Death Syndrome (7).  View Article

References:  
(1) Montgomery SM, Ekborn A.  Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort.  BMJ.  2002,324:26-27.  View Article
(2)  CD Drews, CC Murphy, M Yeargin-Allsopp and P Decoufle  The relationship between idiopathic mental retardation and maternal smoking during pregnancy. Pediatrics.  1996, 97: 547-553. View Article
(3)  USMC National Health Naval Research Center - San Diego, CA.
(4)  J Little, A Cardy, M Gilmour, Smoking and Orofacial Clefts: A United Kingdom–Based Case-Control Study  The Cleft Palate-Craniofacial Journal:   2004:41; 381–386.  View Article
(5)  Smoking During Pregnancy -- United States 1990-2002  MMWR  2004:53;911-915.  View Article
(6)  State Estimates of Neonatal Health - Care Costs Associated with Maternal Smoking -- United States 1996.   MMWR 2004:53;915-917.  View Article
(7)  Kentucky Epidemiologic Notes and Reports.  2004:391-6  View Article  

This is a progressive wasting of the lungs which is most commonly caused by chronic smoking.  Patient's afflicted with emphysema experience a slow loss of breath.  If not caught early, many patients must use home oxygen and experience a slow suffocating death. 

Training Injuries: 

Smokers have more training injuries.  Training injuries are the number one reason marine cadets do not make the core.  These injuries include:  Tendonitis, stress fractures, frostbite and more foot blisters.  Nicotine is a vasoconstrictor and decreases blood flow to tissues increasing their susceptibility to injury and decreases their ability to heal.  Ref: USMC National Health Naval Research Center - San D

Smokers have less stamina than non-smokers.  They can not run as fast, have les muscular endurance and there immune system is not as strong.  Smokers get sicker more often especially with bronchitis and take longer to recover.  Non-smokers are steadier and have better night vision.  Smoking is not allowed in USMC boot camp. 
Ref: USMC National Health Naval Research Center - San Diego, CA.

Gum, Dental and Mouth Disease

To the right is a picture of a hairy tongue caused by poor mouth hygiene and smoking.
 
Click on Pictures to Enlarge
    

Ear Infections and URI's  
 
Smoker's Rhinitis: 

Tobacco smoke contains hundreds of chemicals and at least forty of which have been implicated in cancer. Smoking irritates the lining of the nose, increasing nasal secretions and swelling.  The increase in secretions are caused by goblet cell hyperplasia ( See Brown & Williamson Research Document ).  The cilia (microscopic hair like structures which transport fluids) in the nose has its function inhibited and the nose becomes less able to cleanse itself and more susceptible to allergens ( See British-American Tobacco Co Research Document ).  Thus if you smoke, treatments for allergy are less likely to be effective because the nose has a reduced ability to clean itself of the allergic particles that are inhaled.  Smoking and secondhand smoke is associated with significant nasal and sinus disease and symptoms. View Abstract  
  
Shown to the left, is a picture of a dry pale inside of a nose in a 100 pack/year  patient with smoker's rhinitis. In my (Dr. Kevin Kavanagh's) experience, decongestants, antihistamines and nasal steroids are of little help.  In my practice, I have not had a single allergic patient who smokes improve with allergy shots.  Some doctors will not even allergy test patients that smoke, and for the most part I follow this practice.      
Click on Pictures to Enlarge

Unfortunately, most patients have caused irreversible damage to the lining of their nose and quitting smoking does not improve their symptoms.  Many patients experience a worsening of their symptoms since goblet cell hypertrophy takes place which increases nasal secretions.  Because cillary function (micro hair structures which clean the nose) is often permanently damaged, these secretions are not cleared and the patient experiences worsening over many months of his/her symptoms.  The best treatment is to quit smoking and use hypertonic saline nasal irrigations (over-the-counter buffered hypertonic nasal spray) in combination with the use of nasal steroids.  However, as with patients with chronic lung disease from smoking, patients with smoker's rhinitis, seldom return to a completely normal state.

IF YOU SMOKE..QUIT!!         Search PubMed for Smoking and Rhinitis