Study of Twins Shows How Smoking Ages the Face

Siblings who smoked had more wrinkles, creases, droops and jowls

A study comparing the faces of identical twins confirms what many smokers fear -- the habit does prematurely age a person's skin, taking a serious toll on looks even after just five years.

Researchers from Case Western Reserve University in Ohio used the annual Twins Day Festival in Twinsburg, Ohio, to identify 79 pairs of twins in which one sibling smoked and the other didn't.

The twins who were smokers showed many more signs of skin aging, the researchers found. Their faces featured more wrinkles, creases, droops and jowls.

"Smoking harms virtually every organ in the body, including your skin," said Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids. "Whether you are doing it for vanity or your health, one of the most important health decisions of your life is not to start smoking, or to quit if you have."

The research team attended the Twins Day Festival every year between 2007 and 2010, eventually finding 79 pairs of twins to compare. The twins filled out questionnaires regarding their smoking and lifestyle, and professional photographers snapped individual pictures of them both.

A panel of three plastic surgeons then analyzed the twin's facial features, grading the amount of aging they saw in each person's face using a standardized assessment tool. The researchers used questionnaire results to control for other factors that might prematurely age skin, including sun damage, alcohol use and work stress.

Twins who smoke, when compared to their nonsmoking siblings, had worse scores for baggy eyes, baggy cheeks, smile lines and wrinkles along their upper and lower lips.

Researchers also compared the faces of twins who both smoke, but one of the pair had been smoking for at least five years longer than his or her sibling. They found more baggy eyes, baggy cheeks and lower-lip wrinkles in twins who had been smoking longer.

The judges identified the smoking twin as appearing older in photographs 57 percent of the time compared with the nonsmoking twin, and the twin who had smoked for a longer period of time was identified as older about 64 percent of the time.

The premature aging caused by smoking seemed to mainly affect the lower two-thirds of a person's face, the authors said. There were no apparent differences between smokers and nonsmokers when it came to forehead wrinkles or crow's feet, for example.

The study was published in the November issue of the journal Plastic and Reconstructive Surgery.

Smoking can affect a person's skin tone by robbing cells of needed oxygen, said Dr. Cheryl Healton, president and CEO of the anti-tobacco advocacy group Legacy.

"It's widely known that tobacco causes cardiac problems and disrupts oxygenation," Healton said. "Getting good oxygenation really affects a person's complexion."

Smoking also might cause wrinkles, folds and droops by damaging connective fibers like collagen and elastin that help maintain skin elasticity, the researchers added.

"A less taut skin envelope cannot counteract the effects of gravity," they said.

Healton said people should heed the findings as yet another reason to quit smoking immediately. As the study found, even five years can make a difference, she said.

"It's really bad to smoke, and it definitely affects your appearance," she said. "Not smoking is good for your looks."

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Flu Can Kill Even Healthy Children, Study Finds

Unvaccinated kids are at greater risk, CDC researcher says

Children, even those without severe medical conditions, can die from the flu in as little as three days after symptoms appear, U.S. health officials warn.

Between 2004 and 2012, flu complications killed 830 children in the United States, many of whom were otherwise healthy, according to the U.S. Centers for Disease Control and Prevention.

Most striking is that 35 percent of these children died before being hospitalized or within the first three days of developing symptoms, according to the report published online Oct. 28 in Pediatrics.

"We found these influenza-related deaths can occur in children with and without medical conditions and in children of all ages, and that very few of these children have been vaccinated," said lead author Dr. Karen Wong, a CDC medical epidemiologist.

Researchers who reviewed those deaths found that only 22 percent with a high-risk medical condition and just 9 percent without a significant medical condition had been vaccinated.

Wong doesn't know why so many children die so fast. "About a third of these children die within the first three days of their first reported symptoms," she said.

One expert wasn't surprised that many otherwise healthy children who died did so before being admitted to the hospital.

"First, parents don't realize that flu can be fatal," said Dr. Marcelo Laufer, a pediatric infectious diseases specialist at Miami Children's Hospital.

Second, parents of children with chronic diseases "know the system better, so they come earlier than healthy patients," he said.

Because flu can progress so quickly, prevention is really the best strategy, Wong said. "And that's why we recommend every child 6 months or older get vaccinated every year," she said.

Because an infant under 6 months of age can't be given flu vaccine, Wong said it is vital that pregnant women get a flu shot to help protect their newborn, and that everyone likely to be near the baby also be vaccinated so they can't pass flu to the infant.

Wong said children who get the flu need to be watched carefully. She recommends getting in touch with the child's doctor when symptoms start.

"That's especially true for kids with high-risk medical conditions and for very young children," she explained. "These children are at especially high risk for flu complications."

Laufer, however, said a phone call to the doctor isn't enough. "It's very difficult for a pediatrician on the other side of the phone to understand how sick the child really is," he said.

Parents should take their child to the doctor or emergency department if they're sicker than what one would expect with a common cold, he said.

"Parents should realize that influenza is much more than sniffles," Laufer added. "A kid with influenza is a kid who is very sick, is a kid who is lethargic, has decreased appetite, is not drinking as much and not urinating as much in addition to other flu symptoms," he said.

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E-Cigarettes May Not Be Gateway to Smoking: Study

It found few teens go on to smoke cigarettes, use other kinds of tobacco after 'vaping'

E-cigarettes don't appear to entice teens to try smoking tobacco, a new study says.

The researchers noted that doesn't mean that e-cigarettes are risk-free, but it should reassure parents that teens who try the devices may simply be doing so for the novelty and aren't necessarily setting themselves up for a lifetime of nicotine addiction.

Last month, the U.S. Centers for Disease Control and Prevention warned that "vaping," or inhaling the nicotine vapors from e-cigarettes, might be a dangerous new fad that could set teens up for smoking.

In just one year, the number of kids in grades six through 12 who said they'd ever tried an e-cigarette more than doubled, rising from 3.3 percent to 6.8 percent. Among the 2.1 percent who said they were current e-cigarette users, more than three-quarters said they also smoked regular cigarettes.

Given that overlap, many health experts worried that e-cigarettes might be acting like a gateway drug, sucking kids more deeply into nicotine addiction, and law officials urged the U.S. Food and Drug Administration to regulate e-cigarettes as tobacco products.

The new study suggests that may not be the case.

Researchers surveyed 1,300 college students about their tobacco and nicotine use. The average age of study participants was 19.

"We asked what the first tobacco product they ever tried was and what their current tobacco use looked like," said researcher Theodore Wagener, an assistant professor of general and community pediatrics at the University of Oklahoma Health Sciences Center, in Oklahoma City.

Overall, 43 students said their first nicotine product was an e-cigarette. Of that group, only one person said they went on to smoke regular cigarettes. And the vast majority who started with e-cigarettes said they weren't currently using any nicotine or tobacco.

"It didn't seem as though it really proved to be a gateway to anything," said Wagener, who presented his findings at a meeting of the American Association for Cancer Research, in National Harbor, Md.

Study findings presented at medical conferences are considered preliminary since they haven't been carefully reviewed by outside experts for publication in a medical journal.

E-cigarettes, which use a heating element to vaporize a liquid nicotine solution, are relatively easy for teens to purchase.

While federal rules block the sale of regular cigarettes to anyone under age 18, there are currently no such rules for e-cigarettes. About half of states prohibit the sale of e-cigarettes to minors, but they can also be bought online.

The devices are advertised on TV and popular YouTube videos. They come in sweet flavors that appeal to teens like green apple, watermelon and bubble gum.

"The use of these products is increasing dramatically," while little is known about the risks, said Scott Leischow, who co-leads the cancer prevention and control program at the Mayo Clinic in Scottsdale, Ariz.

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