Public health efforts to reduce smoking could have the added benefit of decreasing the incidence of psoriasis, according to researchers.

Smoking is an independent risk factor for the development of psoriasis, and patients with established psoriasis continue to smoke more than patients without the condition, April W. Armstrong, MD, MPH, and colleagues reported in the British Journal of Dermatology.

They conducted a systematic review and meta-analysis to assess the prevalence of smoking among patients with psoriasis and how smoking contributes to psoriasis incidence.

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Data from 25 prevalence studies included a total of 146,934 patients with psoriasis and 529,111 patients without psoriasis. An association between psoriasis and current smoking (pooled odds ratio, 1.78; 95% CI:1.52 -2.06), as well as between psoriasis and former smoking (pooled OR 1.62; 95% CI: 1.33–1.99), was observed.

Both current and former smokers were more likely to develop incident psoriasis, compared with nonsmokers, according to the three incidence studies included in the systematic review.

Additional factors associated with increased odds of developing psoriasis included a greater number of cigarettes smoked per day, longer durations of smoking habits, and greater pack-years of smoking.

Similar results were found with the prevalence studies: patients with psoriasis were more likely to be either current or former smokers compared with those without psoriasis.

The researchers also said that pathophysiological mechanisms are likely associated with smoking and psoriasis.

“Patients who smoke should be informed of the increased risk of developing psoriasis as well as the additional adverse effects that any amount of smoking can have on one’s health,” the researchers concluded. “Patients with established psoriasis should also be strongly counselled to quit smoking in order to minimize the risk of cardiovascular comorbidities associated with psoriasis.”


  1. Armstrong AW. Br J Dermatol. 2014;170;304-314;doi: 10.1111/bjd.12670.