
SMOKING MAKES YOU LOOK OLDER—IT’S A FACT
Not that we had any doubts, but a recent study confirms the honest to goodness aging effects caused by smoking.
In a twin study conducted in Twinsburg, Ohio, researchers verified that smokers show more premature aging, including wrinkles, nasolabial folds, and sagging upper eyelids. The study appears in the November issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).
The study began with the researchers visiting the annual Twin Days Festival in Twinsburg, Ohio. There, they identified 79 pairs of identical twins who had different smoking histories—either one twin smoked and the other didn’t, or one twin smoked at least 5 years longer. The twin’s average age was 48 years and 57 of the 79 pairs studied were women.
The goal of the study was to identify “specific components of facial aging: that were affected by smoking, according to the report published by ASPS Member Surgeon Bahman Guyuron, MD, professor and chairman, Department of Plastic Surgery, University Hospital and Case School of Medicine, Cleveland, Ohio.
Using close-up photographs, plastic surgeons analyzed the twins’ facial features, including grading of wrinkles, redundant skin around the eyes, and general sagging.

The twin on the left has smoked 17 years longer than the twin on the right. Note the differences in lower lid bags and upper and lower lip wrinkles. Photo Credit: Plastic and Reconstructive Surgery.
The study results showed that the effects of smoothing are most apparent in the lower two-thirds of the face. Smoking twins compared with their nonsmoking counterparts had worse scores for upper eyelid skin redundancy, lower lid bags, malar bags, nasolabial folds, upper lip wrinkles, lower lip vermillion wrinkles, and jowls. Smokers exhibited greater loss of elasticity in their skin, which accounts for the more pronounced wrinkles and sagging. The overall thickness of skin was greater in nonsmokers.
In nearly all cases, the evaluators were able to identify the smoking twin from the non-smoker from the photographs. While age related changes in the middle and lower face were worse in the smoking twins, there were fewer difference in the upper face, such as forehead wrinkles or crow’s feet.
â€It is noteworthy that even among sets of twins where both are smokers, a difference in 5 years or more of smoking duration can cause visibly identifiable changes in facial aging,†wrote Dr. Guyron and his coauthors.