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Cigarette Smoking: Risk Factor for Premature Facial Wrinkling

Donald P. Kadunce, MD; Randy Burr, MD; Richard Gress, MS; Richard Kanner, MD; Joseph L. Lyon, MD; and John J. Zone, MD
[+] Article and Author Information

Grant Support: By the National Institutes of Health and by the Veterans Affairs Medical Center, Salt Lake City, Utah.

Requests for Reprints: Donald P. Kadunce, MD, Division of Dermatology, Room 4B454, University of Utah Health Sciences Center, 50 North Medical Drive, Salt Lake City, UT 84132.

Current Author Addresses: Drs. Kadunce, Burr, and Zone: Division of Dermatology, Department of Medicine, University of Utah Health Sciences Center, Salt Lake City, UT 84132.

Mr. Gress and Dr. Lyon: Department of Family and Preventive Medicine, University of Utah Health Sciences Center, Salt Lake City, UT 84132.

Dr. Kanner: Division of Pulmonary, Critical Care and Occupational Medicine, University of Utah Health Sciences Center, Salt Lake City, UT 84132.


© 1991 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1991;114(10):840-844. doi:10.7326/0003-4819-114-10-840
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This excerpt has been provided in the absence of an abstract.

Objective: To determine if cigarette smoking is a risk factor for the development of premature facial wrinkling.

Design: Cross-sectional study.

Setting: Smoking cessation clinic and community.

Patients: Convenience sample of 132 adult smokers and non-smokers in 1988.

Measurements: A questionnaire was administered to quantify cigarette smoking and to obtain information about possibly confounding factors such as skin pigmentation, sun exposure, age, and sex. Wrinkling was assessed using photographs of the temple region, and a severity score based on predetermined criteria was assigned. A logistic regression model, which controlled for confounding variables, was developed to assess the risk for premature wrinkling in response to pack-years of smoking.

Main Results: The prevalence of premature wrinkling was independently associated with sun exposure and pack-years of smoking. After controlling for age, sex, and sun exposure, premature wrinkling increased with increased pack-years of smoking. Heavy cigarette smokers (> 50 pack-years) were 4.7 times more likely to be wrinkled than nonsmokers (95% CI, 1.0 to 22.6; P value for trend = 0.05). Sun exposure of more than 50 000 lifetime hours also increased the risk of being excessively wrinkled 3.1-fold (CI, 1.2 to 7.1). When excessive sun exposure and cigarette smoking occurred together, the risk for developing excessive wrinkling was multiplicative (prevalence ratio of 12.0; CI, 1.5 to 530).

Conclusion: Cigarette smoking is an independent risk factor for the development of premature wrinkling.

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