Tell-tale signs of a chronic smoker (2024)

Tell-tale signs of a chronic smoker (1)

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Lung India. 2013 Jan-Mar; 30(1): 79–81.

PMCID: PMC3644846

PMID: 23661928

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Sir,

Tobacco smoking is quite common in all sections of Indian society and two main forms of tobacco are cigarette and biri. Biri is formed by stuffing tobacco inside tendu leaves and tied with a thread at one end. Biri has no filter, and to keep it burning one has to take an average of 28 puffs as opposed to 10 in a cigarette. Heavy smokers and chronic smokers have many reliable clinical signs that point towards their habit of smoking, and can be handy in suspecting and diagnosing chronic obstructive airways disease (COAD) at an early stage, even if the patient denies smoking. In this work, we present a list with description of various clinical signs of smokers. Some of the signs (e.g., Chingari sign) may be more specific for biri smokers, whereas others are seen with any type of smoking.

Tell-tale signs of smoking

  1. Stains

    1. Nails and fingers: Nails and fingers of smokers may take a yellow stain due to repeated exposure to smoke and tar in smoke.

    2. Moustaches: Moustaches especially is elderly with white hair show a clear pattern of yellowing in centre showing chronic exposure to smoke [Figure 1].

      Tell-tale signs of a chronic smoker (2)

      Moustaches of an elderly person showing yellow stain more in the center where smoke is exhaled from nose, a sure sign of heavy smoking

    3. Lips: Lips have a bluish-black discoloration in heavy smokers.

    4. Teeth: Teeth of smokers show brownish black staining from inside and yellow discoloration from outside.

  2. Burns

    1. Clothes: ‘Chingari sign’: Clothes of biri smokers have numerous holes due to sparks (Chingari in Hindi) arising from burning of biris over many months [Figure 2].

      Tell-tale signs of a chronic smoker (3)

      Shirt of a patient showing multiple tiny holes produced by the sparks (‘Chingari’ in Hindi) originating from the Biri smoking (Biri is tobacco rolled in Tendu eaves). It is the most prevalent form of smoking in India and this sign is called ‘Chingari Sign’ seen only in Biri smokers

    2. Fingers: Fingers of biri smokers may show burn marks due to repeated exposure to matchsticks used to burn biris.

  3. Skin changes

    1. Premature wrinkling: ‘Crows feet’, ‘cobblestone wrinkles’, ‘smoker's face’: The term smoker's face was coined by Dr. Douglas Model in 1905 in an article published in British Medical Journal.[1] His observation was that half of the long-term smokers (>10 years) had similar skin features in face irrespective of age, sun exposure, or weight. Toxins from smoke caused constriction of blood vessels, presence of carbon monoxide reduced oxygen delivery to skin, and direct exposure of facial skin to smoke caused dryness and irritation. In addition, nicotine has some diuretic effect to reduce the skin moisture. Crow's feet [Figure 3a] is the prominent lines and wrinkles starting from the corner of the eyes. Cobblestone wrinkles [Figure 3b] are wrinkles that run down at the back of the neck. Smokers also produce matrix metalloproteinase in excess, which degrades collagen and skin loses elasticity as a result.[2]

      Tell-tale signs of a chronic smoker (4)

      a: A typical “smoker's face” showing dryness of skin, wrinkles originating from the sides of eyelids running up to cheek called “crow's feet”, wrinkles in front of the ears, and wrinkles running down the neck behind the ears

      Tell-tale signs of a chronic smoker (5)

      Cobblestone-shaped wrinkles in the side and back of the neck of a smoker, a feature of heavy smoking over prolonged duration

    2. Nodular elastosis of skin with comedone formation: “Favre–Racouchot syndrome” [Figure 4].

      Tell-tale signs of a chronic smoker (6)

      Favre–Racouchot syndrome: showing multiple open and closed comedones (black heads) over forehead and furrowed wrinkled skin, produced by chronic sun exposure and heavy smoking

      The disease was originally described by Favre in 1932 and reviewed in detail by Favre and Racouchot in 1951.[3,4] This disease is a cosmetic concern and is caused by chronic excessive exposure to ultraviolet (UV) light in sun and is strongly associated with heavy cigarette smoking.[5] The association with smoking has been found to be even stronger than UV light.

      Multiple open and closed comedones are present in the periorbital and temporal areas with yellowish discoloration, yellowish nodules, atrophy, wrinkles, and furrows. The eruption is usually bilaterally symmetrical. No inflammation is present, unlike the comedones seen in acne vulgaris.[6]

  4. Smell of smoke

    1. Heavy smokers have a typical smell of smoke in their clothes, breath, hands, and can easily be detected by this smell. The smell may vary depending on the type of cigarette they use. So, if in doubt regarding the history using your smelling power may be worthwhile, especially in adolescents.

Association of these signs with diseases

Facial wrinkling and association with chronic obstructive pulmonary disease (COPD):[7] In a recent study on chronic smokers, the investigators found statistically significant correlations between facial wrinkling and both low FEV1 and extensive disease on computed tomography (CT). The authors suggest that genetic susceptibility might be the mechanism behind this correlation: Smoking might activate metalloproteinases in susceptible individuals, or such individuals might have defective repair mechanisms affecting both skin and lungs. If we are able to detect the signs in skin such as Crow's feet on face in smokers at an early age, we can alert these patients regarding high likelihood of development of COAD because of common proposed mechanism for both processes, that is, destruction of airways and wrinkling of face by activation of metalloproteinases by smoking. We can also get their pulmonary function tests or chest CT to detect COAD at an early stage.

REFERENCES

1. Model D. Smoker's face: An underrated clinical sign? Br Med J (Clin Res Ed) 1985;291:1760–2. [PMC free article] [PubMed] [Google Scholar]

2. Lahmann C, Bergemann J, Harrison G, Young AR. Matrix metalloproteinase-1 and skin ageing in smokers. Lancet. 2001;357:935–6. [PubMed] [Google Scholar]

3. Favre M. A reason for some localized pilosebaceous units on the face. Bull Soc Fr Dermatol Syph. 1932;39:93–6. [Google Scholar]

4. Favre M, Racouchot J. Nodular cutaneous elasteidosis with cysts and comedones. Ann Dermatol Syphiligr (Paris) 1951;78:681–702. [PubMed] [Google Scholar]

5. Keough GC, Laws RA, Elston DM. Favre-Racouchot syndrome: A case for smokers’ comedones. Arch Dermatol. 1997;133:796–7. [PubMed] [Google Scholar]

6. Patterson WM, Fox MD, Schwartz RA. Favre-Racouchot disease. Int J Dermatol. 2004;43:167–9. [PubMed] [Google Scholar]

7. Patel BD, Loo WJ, Tasker AD, Screaton NJ, Burrows NP, Silverman EK, et al. Smoking related COPD and facial wrinkling: Is there a common susceptibility? Thorax. 2006;61:568–71. [PMC free article] [PubMed] [Google Scholar]

Articles from Lung India : Official Organ of Indian Chest Society are provided here courtesy of Wolters Kluwer -- Medknow Publications

Tell-tale signs of a chronic smoker (2024)

FAQs

What are the signs of chronic smoker? ›

Symptoms include shortness of breath, coughing, fatigue, sleep and heart problems, weight loss, and depression.
...
What are the risks linked to smoking?
  • Cough.
  • Chest pain.
  • Shortness of breath.
  • Wheezing.
  • Recurring lung infections.
  • Bloody or rust-colored sputum.
  • Hoarseness.
  • Swelling of the neck and face.

How much do you have to smoke to be considered a chronic smoker? ›

Abstract. Background: Heavy smokers (those who smoke greater than or equal to 25 or more cigarettes a day) are a subgroup who place themselves and others at risk for harmful health consequences and also are those least likely to achieve cessation.

What does chronic smoker mean? ›

But if you're a chronic smoker, you've been smoking for a long time and will have a hard time stopping. The word chronic is used to describe things that occur over a long period of time and, in fact, comes from the Greek word for time, khronos.

How can doctors tell if you are a smoker? ›

Medical tests can detect nicotine in people's urine, blood, saliva, hair, and nails. When someone smokes a cigarette, their body absorbs up to 90 percent of the nicotine. Traces of nicotine will linger long after individuals no longer feel the effects.

What are common traits of a smoker? ›

Studies reveal that smokers tend to be more extroverted, anxious, tense, and impulsive, and show more traits of neuroticism and psychoticism than do ex-smokers or nonsmokers. The literature also reveals a strong association between smoking and mental disorders, such as schizophrenia and depression.

What is a heavy or chronic smoker? ›

In general, a light smoker is someone who smokes less than 10 cigarettes per day. Someone who smokes a pack a day or more is a heavy smoker. An average smoker falls in between. Sometimes a doctor will use the term pack year to describe how long and how much a person has smoked.

Can lungs heal after 40 years of smoking? ›

He added: "There is a population of cells that, kind of, magically replenish the lining of the airways. "One of the remarkable things was patients who had quit, even after 40 years of smoking, had regeneration of cells that were totally unscathed by the exposure to tobacco."

Can a dentist tell a smoker? ›

The truth is, yes, your dentist can tell if you have been smoking. Here are some ways that your dentist can tell if you are smoking: Nicotine can stain your teeth – when nicotine mixes with your saliva, it creates yellow or brown stains on your teeth. The more your smoke, the more the stain seems to accumulate.

What does smoking do to your lips? ›

Reduced blood flow and exposure to tar and nicotine can also cause the melanin in your lips and gums to darken, leading to uneven pigmentation. They may appear blotchy, purple, dark brown, or black. The chemicals in cigarettes also have negative effects on the skin.

What is smokers life expectancy? ›

Cigarette smoking causes premature death: Life expectancy for smokers is at least 10 years shorter than for nonsmokers. Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by about 90%.

Can you live a long life as a smoker? ›

We take a look at some stats... Researchers at 'Action on Smoking and Health' have reported that a 30-year-old smoker can expect to live about 35 more years, whereas a 30-year-old non-smoker can expect to live 53 more years.

How many pack years is chronic smoker? ›

1 – 20 Pack Years – Light Smokers. 1 – 40 Pack Years – Moderate Smokers. More than 40 Pack Years – Heavy Smokers.

What are 3 conditions a smoker is likely to suffer from? ›

Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.

Why do some smokers live long? ›

Study finds some individuals have genetic variants that allow them to have long-term exposure to a carcinogen without developing lung cancer.

Can you recover from chronic smoking? ›

Quitting smoking offers lung and heart health benefits

“But if you quit by age 30, you can recover almost all of them. One year after quitting smoking, your risk of having a heart attack goes down by half, too. And four years later, your risk reverts to the same as a non-smoker's.

What are the three types of smokers? ›

There are three main types of smoker grill options: gas, electric and charcoal.

Does smoking alter personality? ›

Compared to non-smokers, current smokers were more likely to increase on neuroticism and to decline on extraversion, openness, agreeableness and conscientiousness over time.

What color is a good smoker? ›

Blue smoke for long cooks. Smoke from wood or charcoal for cooking can range from bluish, to white, to gray, to yellow, brown, and even black. The most desirable smoke is almost invisible with a pale blue tint.

What are the levels of smokers? ›

“Light and Intermittent Smokers” smoke 1-39 cigarettes per week, or an average of 10 CPD, or 1-4 grams of tobacco per day, and have never smoked daily. “Low-level Smokers” smoke < 20 CPD and < 1 pack per week. “Low-rate smokers” smoke < 5 CPD and never more than 10 CPD.

How many cigarettes a day is too much? ›

Lung and Other Cancers

For daily smokers (> 20 cig/day), the risk of dying from lung cancer is more than 23 times higher in men and about 13 times higher in women than nonsmokers (1). The risks for light smokers, while lower, are still substantial.

Can ex smokers regain lung capacity? ›

After Quitting, Lungs Don't Fully Recover

The new study shows that although lung capacity declines at a much lower rate in ex-smokers (an extra 1.57 mL/year compared with nonsmokers) than current smokers (an extra 9.42 mL/year), the rate doesn't normalize (reach zero) for at least 30 years.

Is it too late to stop smoking at 60? ›

It's never too late to get benefits from quitting smoking. Quitting, even in later life, can significantly lower your risk of heart disease, stroke, and cancer over time and reduce your risk of death.

How long does it take for smoking to affect your teeth? ›

Variables such as your current oral health, diet, how much you smoke, and how often you light up can determine how long it takes for smoking to affect oral health. However, it's important to know that in as little as one week of smoking, your oral health may become noticeably compromised.

How can I hide my smoking from the dentist? ›

Many smokers try to disguise their habit by covering up the smell with gum, mints, or mouthwash.

How often should a smoker see the dentist? ›

Both heavy and recreational smokers are advised to see their dentist 3-4 times a year. Along with cigarette smokers, people who use drugs also should see a dentist more frequently – particularly those who smoke their drug of choice.

Do smokers lips ever go away? ›

The skin will generally go back to normal after you have finished smoking a cigarette. But the effects of smoking combined with repeated movements plus time can cause those lines to become permanent.

Can you reverse smoking damage? ›

If you are a smoker, please understand that you can potentially reverse years of damage caused by smoking if you stop today. The FDA and CDA say that within 12 hours after your last cigarette, the carbon monoxide level in your blood returns to a normal level and increases oxygen-blood flow.

What is smokers melanosis? ›

Smoker's melanosis (see Right) is increased tissue pigmentation, or darkening, due to irritation from tobacco smoke. Typically this pigmentation occurs on the gingiva (gums) of the upper and lower front teeth.

What is the average lifespan of a smoker? ›

The study showed that male smokers who make it to 70 years old still lose about four years off their life, with projections of 88, 86 and 84 for nonsmokers, former smokers, and current smokers, respectively.

Can a smoker be healthy again? ›

When it comes to cancer prevention, the damaging effects of smoking can't be reversed by exercise or a healthy diet. There's no such thing as a healthy smoker - especially when it comes to cancer prevention.

Why do some heavy smokers live so long? ›

Study finds some individuals have genetic variants that allow them to have long-term exposure to a carcinogen without developing lung cancer.

What is the longest living smoker? ›

The world's documented longest-living person, Jeanne Calment, was a smoker for most of her life, and another claimant to the title is said to smoke a pack a day.

Is it worth giving up smoking at 50? ›

It's never too late to get benefits from quitting smoking. Quitting, even in later life, can significantly lower your risk of heart disease, stroke, and cancer over time and reduce your risk of death.

Can your lungs go back to normal after smoking for years? ›

While lung tissue cells do regenerate, there's no way a smoker can return to having the lungs of a non-smoker. At best, they will carry a few scars from their time smoking, and at worst, they're stuck with certain breathing difficulties for the rest of their lives.

How old is the oldest living smoker? ›

Cigarette smoking Brazilian man may be world's oldest person at 126 years old. All things considered, Jose Aguinelo dos Santos is a pretty lively Brazilian man.

What is worse alcohol or cigarettes? ›

While drinking can be a threat to your health, smoking is certainly worse. Unlike alcohol at low or moderate levels, there is no benefit to tobacco use at any level. When you smoke, you inhale various chemicals that can injure cells, causing both cancer and artery damage (e.g. heart attacks and strokes).

How many years do smokers lose off their life expectancy? ›

Cigarette smoking causes premature death: Life expectancy for smokers is at least 10 years shorter than for nonsmokers. Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by about 90%.

Why do some smokers never get sick? ›

The mystery of why some people are able to smoke heavily without developing a lung condition has been explained by scientists. Mutations in DNA enhance lung function in some people and protect them against the often deadly impact of smoking, according to the Medical Research Council.

How do you clean tar off your lungs? ›

Are there natural ways to clean your lungs?
  1. Coughing. According to Dr. ...
  2. Exercise. Mortman also emphasizes the importance of physical activity. ...
  3. Avoid pollutants. ...
  4. Drink warm fluids. ...
  5. Eat anti-inflammatory foods.

How do you clean your lungs after smoking? ›

Exercise Regularly

Exercise increases the amount of oxygen that gets delivered to cells and tissues throughout your body. Cardiovascular exercises like brisk walking, swimming, running, and cycling are ideal for helping to clear out your lungs after you quit smoking.

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