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Smokers' Wrinkles

Harry W. Daniell, MD
JAMA. 1973;226(7):788-789. doi:10.1001/jama.1973.03230070048020.
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To the Editor.—  Drs. Allen, Diamond, and Johnson (225:1067, 1973) clearly indicate that they believe their studies discredit my own, but their conclusions are based on assumptions that seem unlikely to be valid, and the fragmentary data which they report, surprisingly enough, support my conclusions rather than theirs.It seems self-evident that wrinkles can only develop in wrinkle-prone skin, and that important factors relating to wrinkle development at a susceptible site include exposure to solar radiation, repeated local wrinkling (as occurs during facial expression), and the passage of time. Using our technique, profound wrinkling was demonstrated to be independently associated with both habitual cigarette smoking and increased outdoor exposure in 1,104 white men and women. The variables of age and weight loss were recognized and controlled. For each ten-year age span between ages 30 and 70, among both men and women, the more exposed nonsmokers were less apt to be


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