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Smoking can cause the following damage to the skin: skin cancer poor wound healing increased infection psoriasis hidradenitis suppurativa bags under the eyes drooping skin deep wrinkles and lines uneven skin tone dry skin While the exact reason behind these changes isnt well understood, most theories suggest premature aging from tobacco is caused by: poor blood flow a breakdown of elastic skin fibers an increase of cell-damaging particles called free radicals The appearance of smoking fingertips can vary from person to person, but it generally involves a yellow-brown stain on the tips of the thumb, index finger, and middle finger

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Data availability All the data in the present analysis is available at NHANES website Abbreviations NHANES: National Health and Nutrition Examination Survey TST: testosterone EST: estrogens SHBG: sex hormone-binding globulin CDC: Centers for Disease Control and Prevention NCHS: National Center for Health Statistics ID-HPLC-APCI-MS/MS: isotope-dilution high-performance liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometric LLOD: lower limit of detection ID-LC-MS/MS: isotope dilution liquid chromatography tandem mass spectrometry BMI: body mass index RCS: restricted cubic spline SD: standard deviation References GBD 2019 Diseases and Injuries Collaborators