Background and aims: Smoking is associated with negative health of skin and increased signs of facial aging. We aimed to address two questions about smoking and appearance: 1) how does smoking affect the attractiveness of faces, and 2) does facial appearance alone provide an indication of smoking status?Methods: Faces of identical twins discordant for smoking were averaged to make male and female smoking and non-smoking prototypes faces. In Task 1, we presented same sex smoking and non-smoking prototypes side-by-side and participants (n=590) indicated which face was more attractive. Participants were blind to prototype smoking status. In Task 2 a separate sample (n=580) indicated which prototype was the smoker.Results: In Task 1 both male and female participants judged non-smoking prototypes more attractive, irrespective of the sex of the prototype face. In Task 2, both male and female participants selected the smoking prototype as the smoker more often, again irrespective of the sex of the prototype face.Conclusions: Our findings provide evidence that smoking may negatively impact facial appearance, and that facial appearance alone may be sufficient to indicate smoking status. We discuss the possible use of these findings in smoking behaviour change interventions.
