If you need a powerful reason to quit smoking, look no further than this remarkable study involving identical twins. Once indistinguishable, the twins now bear dramatically different appearances— all because one took up smoking for over five years while the other remained smoke-free.
Identical twins provide a unique natural experiment, controlling for genetics and lifestyle factors, making the visible changes in the smoker’s face even more compelling. The twin who smoked has experienced rapid ageing, with clear physical differences becoming impossible to ignore.
Smoking accelerates the ageing process by damaging skin, leading to dull complexion, deep wrinkles, sagging skin, and yellowed teeth. These effects are especially visible around the eyes and mouth, where the smoker’s skin has lost elasticity and firmness.
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Research from the American Society of Plastic Surgeons has repeatedly used twins to highlight how smoking impacts facial ageing. One significant study found a marked disparity in the severity of ageing signs such as lower eyelid bags, malar bags under the eyes, and wrinkles around the lips between smoking and non-smoking twins.
Dr. Bahman Guyuron, who led the study, explained the biological reasons behind these changes: smoking reduces collagen production while increasing collagen breakdown, which damages skin structure and circulation. Additionally, nicotine thins the skin, further decreasing its elasticity and speeding up premature ageing.
In 2025, Dr. Guyuron told CNN that he can often identify smokers by the “festoons of loose skin” beneath their eyes—a clear hallmark of smoking-related damage. In the case of the twins, these features tell a vivid story of tobacco’s harsh toll over just a few years.
This compelling evidence from identical twins makes the risks of smoking far more tangible, reminding us all that the cost of tobacco is written clearly on the face.