The incidence of cutaneous malignant neoplasms, including BCCs and SCCs, is constantly rising globally. These keratinocytic cancers are the most common cancers in the white population.1 Knowing this, it is no surprise that dermatologists, surgeons, and general practitioners will encounter an increasing number of patients with these tumors. Keratinocytic cancers result from complex interactions between environmental exposure (eg, lifestyle factors), phenotypic characteristics, and genetic predisposition. This systematic review and meta-analysis by Leonardi-Bee et al2 has taken a closer look at smoking as a potential risk factor for BCC and SCC. The most important conclusion is confirmation of an independent association between smoking and the increased likelihood of SCC development by more than 50% (OR, 1.52; 95% CI, 1.15-2.01). This finding was based on pooled data of 6 relatively small studies, of which only 1 had a prospective cohort design. The generalizabilty of the findings is likely to be moderate because the heterogeneity was quite high (I2 = 64%).