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Updated: Aug 14, 2026

Measuring Psoriasis Severity at Home
Published on: March 1, 2024
Relationship between smoking and the clinical severity of psoriasis
Cristina Fortes1, Simona Mastroeni, Karen Leffondré
1Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico, Via dei Monti di Creta 104, 00167 Rome, Italy. c.fortes@idi.it
Objective:
To evaluate the association between different components of smoking history and the clinical severity of psoriasis.
Design:
A hospital-based cross-sectional study.
Setting:
Inpatient wards of a hospital for skin diseases in Rome, Italy.
Patients:
A total of 818 adults with psoriasis.
Main Outcome Measure:
The Psoriasis Area and Severity Index was used to assess the clinical severity of psoriasis between February 21, 2000, and February 19, 2002.
Results:
After adjustment for potential confounders (sex, age, body mass index, psychological distress, family history of psoriasis, duration of psoriasis disease, and alcohol consumption), high intensity of smoking (>20 cigarettes daily) vs a lower level of consumption (< or =10 cigarettes daily) was associated with a more than 2-fold increased risk of clinically more severe psoriasis (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.2-4.1). Cigarette-years, measured as the product of the intensity and duration (years) of smoking, significantly increased the risk of clinically more severe psoriasis after adjustment for confounding factors (OR,1.3; 95% CI, 1.0-1.6, for a 600-U increase in cigarette-years). Separate analyses for men and women showed that the effect of cigarette-years was stronger for women (OR, 1.8; 95% CI, 1.2-2.6, for a 400-U increase in cigarette-years) than for men (OR, 1.2; 95% CI, 0.9-1.6, for a 700-U increase in cigarette-years).
Conclusion:
Smoking is associated with the clinical severity of psoriasis and highlights the importance of smoking cessation in patients with psoriasis.
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