Smoking: The Ugly Truth
According to the Centers for Disease Control and Prevention (CDC), 44.5 million U.S. adults were current smokers in 2006 -- 24% of men and 18% of women. Smoking kills an incredible 438,000 Americans and over three million people worldwide every year.
Smoking is a major cause of cancers of the lung, larynx (voice box), oral cavity, pharynx (throat), esophagus (swallowing tube connected to the stomach), and bladder. It contributes to the development of cancers of the pancreas, cervix, kidney, stomach, and also some leukemias. It is a major cause of heart disease, aneurysms, bronchitis, emphysema, and stroke. If that weren't enough (and there are many more health effects not listed), smoking has also been linked to multiple skin conditions:
- squamous cell carcinoma
- poor wound healing
- complications during reconstructive surgery
- premature skin aging
- hair loss
If you are still not convinced to quit smoking, consider this: the CDC estimates that adult male smokers lose an average of 13.2 years of life and female smokers lose 14.5 years of life because of smoking. Tools and advice are available to help you quit.
Evidence for the Link
Perhaps the best evidence for an association between smoking and skin cancer comes from the study by Sofie De Hertog and colleagues of the Leiden University Medical Center in the Netherlands. The researchers interviewed 580 people who had some form of skin cancer and 386 who did not. They found that in current smokers, the risk of developing squamous cell carcinoma is 3.3 times higher than in non-smokers. No link between smoking an basal cell carcinoma or melanoma was found. Former smokers can substantially reduce their risk of contracting skin cancer, but only to a 1.9 times higher risk. A positive relationship was also observed between the number of cigarettes smoked and elevated risk: in heavy smokers (more than 20 cigarettes a day), the risk runs as high as 4.1, while in smokers who consume less than 10 cigarettes a day, the risk drops to 2.4. Interestingly, no relationship has been found between cigar smoking and incidence of skin cancer, yet pipe smokers had the same risk as cigarette smokers.
How Does the Link Work?
Exactly how tobacco smoke leads to skin cancer remains unclear. It is possible that one of the 3,000 chemicals in tobacco smoke may act as a skin carcinogen (cancer-causing agent), either by direct contact with smoke (which may damage the DNA in skin cells) or by being absorbed by the lungs into the bloodstream. Evidence for this mechanism is that applying tobacco smoke to the skin induced squamous cell carcinoma in animal experiments. Smoking may also induce skin cancer by inhibiting the immune system, since patients with suppressed immune systems due to organ transplants or other causes are more susceptible to squamous cell carcinoma.
Research into the connection between smoking and skin cancer is ongoing. But as Michael Thun, MD, of the American Cancer Society says: "There have been overwhelming health reasons to avoid smoking for a long time. This is one more reason for people to stop smoking or not to start."
"Adult Cigarette Smoking in the United States: Current Estimates." Centers for Disease Control and Prevention. 3 September 2008.
De Hertog SA, Wensveen CA, Bastiaens MT, Kielich CJ, Berkhout MJ, Westendorp RG, Vermeer BJ, Bouwes Bavinck JN; Leiden Skin Cancer Study. "Relation between smoking and skin cancer." J Clin Oncol 2001 19(1):231-8. 3 September 2008.
Freiman A, Bird G, Metelitsa AI, Barankin B, Lauzon GJ. "Cutaneous effects of smoking." J Cutan Med Surg 2004 8(6):415-23. 3 September 2008.
Morita A. "Tobacco smoke causes premature skin aging." J Dermatol Sci 2007 48(3):169-75. 3 September 2008.
"Smoking Linked to Skin Cancer." American Cancer Society. May 2001. 3 September 2008.