The staid peer review periodical, the British Medical Journal, recently featured a picture quiz entitled, "Smokers' Faces: Who Are the Smokers?"1 The faces depicted included that of the late, famed Hollywood screen star, William Holden. The quiz was published as an adjunct to the report, "Smoker's Face: An Underrated Clinical Sign?"2 The author, Dr Douglas Model, reported that, in his study group, approximately half the cigarette smokers who had smoked for ten years or more were identified by their facial features alone. "Smokers' face" was defined as one or more of the following: (1) lines or wrinkles on the face; (2) a gauntness of facial features with prominence of the underlying bony contours; (3) an atrophic, slightly pigmented gray appearance of the skin; and (4) a plethoric, slightly orange, purple, and red complexion. Confounding factors such as exposure to the sun, age, and a recent change in weight
Soffer A. Smokers' Faces: Who Are the Smokers? Arch Intern Med. 1986;146(8):1496. doi:10.1001/archinte.1986.00360200046006
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