Cigarette smoking, hormonal changes, and the skin

The harmful effects of cigarette smoking are not limited only to those tissues with direct contact with the smoke. Smokers have increased risks of cancer of the esophagus, kidney, and bladder, presumably from swallowed or absorbed cigarette products. Some hormonal effects of smoking, such as acute catecholamine and corticosteroid release, appear to be due to the stimulation of the adrenal medulla or of the hypothalamus, with subsequent adrenocorticotropic hormone secretions. Certain other effects on organs lacking direct smoke contact appear to follow an important pattern; in many ways women who smoke cigarettes behave as though they are relatively estrogen deficient. Such an antiestrogenic effect of smoking would of course lead to an exacerbation of estrogendeficiency problems, such as osteoporosis, but would also have unexpected beneficial effects on diseases caused by estrogen excess, such as endometrial cancer. Furthermore, this antiestrogenic effect of smoking seems to affect male smokers as well, with an increased tendency for ischemic heart disease. We review herein various effects of cigarette smoking on the endocrine system.