title: Cigarette smoking: risk factor for premature facial wrinkling.
abstract: OBJECTIVE
  To determine if cigarette smoking is a risk factor for the development of premature facial wrinkling.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Smoking cessation clinic and community.
  
  
  METHODS
  Convenience sample of 132 adult smokers and non-smokers in 1988.
  
  
  METHODS
  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.
  
  
  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 (greater than 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).
  
  
  CONCLUSIONS
  Cigarette smoking is an independent risk factor for the development of premature wrinkling.
authors.affiliation: Division of Dermatology, University of Utah Health Sciences Center, Salt Lake City 84132.
authors.forename: D P
authors.initials: DP
authors.lastname: Kadunce
authors.forename: R
authors.initials: R
authors.lastname: Burr
authors.forename: R
authors.initials: R
authors.lastname: Gress
authors.forename: R
authors.initials: R
authors.lastname: Kanner
authors.forename: J L
authors.initials: JL
authors.lastname: Lyon
authors.forename: J J
authors.initials: JJ
authors.lastname: Zone
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D012307:Risk Factors; D012737:Sex Factors; D015595:Skin Aging / Q000502:physiology / Q000528:radiation effects; D012880:Skin Pigmentation / Q000502:physiology; D012907:Smoking / Q000009:adverse effects*; D013223:Statistics as Topic; D013472:Sunlight / Q000009:adverse effects; D011795:Surveys and Questionnaires