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


Recognition of dermatologic signs of tobacco use can certainly be a clue to many of the serious underlying systemic diseases associated with smoking and smokeless tobacco use. We suggest that the recognition of these dermatologic manifestations can, in addition, be used as a tool to encourage smoking cessation in patients. In a study by Curry et al,[129] the graphic picturing of health effects of smoking was rated by smokers to be an important motivational factor for smoking cessation. For many users of tobacco, however, the more immediate and visible effects of this drug such as wrinkling, yellow teeth, and bad breath may provide a more compelling stimulus for smoking cessation than the knowledge that tobacco kills.[130] The physician can point out the visible effects of tobacco use in the patient and use this to initiate a discussion on the patient's tobacco use and the associated health effects. Although education of the patient on the health effects of tobacco use is an important start, addictions, like other diseases, are not cured by a few choice words. All physicians need to follow discussions on tobacco use with recommendations on how to treat the addiction. Physicians need to be aware of the cessation techniques available and know how to choose the one most helpful to the individual.[131] This may include referral to a community smoking cessation program or treatment with physician follow-up and support via behavioral approaches or pharmacologic interventions. Physicians currently find it easier to deal with the consequences of tobacco use, such as pulmonary and cardiac disease, than to deal with the addiction.[132] It is important that physicians learn to intervene and help their patients quit using tobacco.


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