“Lord, help me quit smoking, but not yet.” Smokers today are well aware of the risks—lung cancer, throat cancer, heart disease, emphysema and so much more—but because if they look healthy on the outside, it’s hard to acknowledge the reality of these potential “inside problems.” A flimsy excuse? Yes, but clearly smoking is a powerful addiction. So maybe a new study revealing an “outside problem” for smokers—an increased risk for potentially disfiguring skin cancer—will help such smokers face up to reality.

The study focused on two types of nonmelamona skin cancer—basal cell carcinoma (BCC), which is rarely fatal but can be disfiguring…and squamous cell carcinoma (SCC), which can cause significant disfigurement and can be deadly. Researchers compared health information on 315 adults who had no history of skin cancer with data on 380 people who had been diagnosed with either BCC or SCC. All study subjects were Caucasian (the group most susceptible to skin cancer) and were asked whether they had ever smoked, for how long and how many cigarettes per day they averaged. In analyzing the data, researchers adjusted for other skin cancer risk factors, such as sun exposure, sunburn history, age, skin tone, and eye and hair color.

Results: Smoking significantly increased women’s odds of developing squamous cell cancer—and the more they smoked, the higher their risk. For instance, women who smoked the equivalent of one pack a day for 20 years had three times the risk for SCC as women with no history of smoking. No connection was found between smoking and BCC in women. Male smokers had a modestly increased risk for both types of skin cancer, but the link wasn’t strong enough for researchers to definitively declare a connection.

Why female smokers would be at significantly greater risk for skin cancer than male smokers isn’t clear, though the researchers pointed out that women smokers also are more likely to get lung cancer. Theory: Estrogen may play a role in the way nicotine is metabolized and in how effectively the body repairs DNA damage caused by smoking, thus influencing a female smoker’s cancer risk.

Takeaway message: Everyone should speak to a dermatologist about the warning signs of skin cancer and appropriate screening schedules—but this is especially important if you have a history of smoking. For help in kicking the cigarette habit, contact a free counseling support system that offers information, coaching and/or opportunities to connect with other smokers who want to quit—according to the US Public Health Service, this more than doubles the chances of success. Options include the toll-free quit line 800-QUIT-NOW (800-784-8669), a federal/state partnership…and the interactive Web sites SmokeFree.gov and Women.SmokeFree.gov from the National Cancer Institute. Your skin will be the better for it—and so will the rest of your body.