Tobacco Use and Skin Disease

Melody Vander Straten, MD, Daniel Carrasco, MD, Martha S. Paterson, MD, Monica L. Mccrary, MD, Diane J. Meyer, MD, Stephen K. Tyring, MD, PhD, Galveston, Tex 

South Med J. 2001;94(6) 

In This Article

Abstract and Introduction


Background. The primary objective of this review is to evaluate the mucocutaneous manifestations of tobacco use.
Methods. Computerized literature searches were conducted for English language articles related to skin/mucous membrane disease and use of tobacco. The primary criterion for assessing data quality and validity was the demonstration of a causal relationship between tobacco use and skin/mucous membrane disease.
Results. This review of the literature shows that a number of disorders and diseases of the skin and mucous membranes are related to tobacco use.
Conclusions. Since millions of persons use tobacco despite its well publicized relationship to increased mortality, knowledge of the mucocutaneous morbidity associated with tobacco use may help physicians in counseling their patients.


Cigarette smoking is the largest preventable cause of death in the United States according to the Centers for Disease Control and Prevention.[1] Furthermore, it is well known that cigarette smoking contributes to an increased risk of cancer, coronary artery disease, stroke, chronic pulmonary disease, and aortic aneurysm. Approximately 1.1 billion people smoke, and smoking kills 1 in 10 adults worldwide.[2]

Fortunately, the annual prevalence of cigarette smoking among adults in the United States declined 40% between 1965 and 1990.[1] However, it has remained practically unchanged during 1990 and 1999 with current estimates of smoking prevalence among men of 28.0% and among women of 22.5%.[1] There has also been an increase in the use of smokeless tobacco between 1970 and 1987 among white men ≤34 years of age.[1]

The latency associated with many tobacco-related diseases ensures that tobacco-induced health problems will continue for many years to come. Although the association between tobacco and cardiovascular disease, pulmonary disease, and cancer is well known to health care professionals, the many skin diseases caused by tobacco use may be less recognizable. In this paper, we outline some of the direct and indirect effects of smoking and smokeless tobacco use that can be detected on dermatologic examination ( Table 1 ).


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