When something is going wrong in your body, there will be signs. They may be subtle, but they are visible in close observation. If you are a smoker, you may be worried about the smell of smoke emanating from your mouth or clothes. However, there are other signs that tell whether you smoke or not and these signs are difficult to get rid of!

Smoking is the harmful act of inhaling tobacco infused smoke and is a common activity all over the world. According to the Center of Disease Control and Prevention (CDC), over 480,000 deaths happen each year due to smoking or smoke inhalation. The organization explained that smoking causes harm to nearly all organs and quitting lowers the risk of early death and other smoking related diseases.

Like many other substances, there are clear tell-tale signs when someone is smoking. This is especially important for finding lung problems like Chronic obstructive pulmonary disease (COPD), which is a lung disease that makes it hard to breathe, sooner so people can get help.

Why Does Smoking Affect Your Physical Appearance?

Action on Smoking and Health (ASH) explains that tobacco smoke has more than 7,000 harmful chemicals like nicotine, carbon monoxide, and various metals like arsenic, cadmium, and lead, quickly reach your lungs and then travel through your blood to all your organs, including your skin. Smoking damages your skin's ability to heal because it increases an enzyme metalloproteinase (MMPs) that breaks down collagen. Collagen is what keeps your skin smooth and elastic. As you lose collagen, your skin sags. Squinting from the smoke and puckering your mouth when smoking also cause wrinkles around your eyes and mouth.

Smoking also reduces blood flow to your skin, which means it gets less oxygen and nutrients. All these things together lead to what doctors call a "smoker's face." Quitting smoking can help prevent or slow down these skin problems."

Visible Signs Of Smoking

Here are some visible signs of smoking in people, according to 2013, Lung India

Fingers and Nails

When people smoke, the tar and other chemicals in the smoke stick to their fingers and nails. This repeated contact causes a yellow stain that's hard to wash off. It's a very common sign that someone regularly handles cigarettes or biris.

Moustaches

Especially in older people with white moustaches, smoking causes a yellowing effect. This is most noticeable in the center of the moustache, where the smoke from the nose directly hits the hair. The consistent exposure to smoke colors the hair over time.

Lips

Heavy smokers often have a bluish-black tint to their lips. This discoloration happens because the chemicals in tobacco smoke affect the blood flow and the color of the skin on the lips. The constant exposure changes the lip's natural color.

Teeth

Smoking causes teeth to stain both inside and out. The outside of the teeth turns yellow from the tar, while the inside develops a brownish-black stain. This happens because the smoke seeps into the enamel and discolors the teeth over time.

Premature Wrinkling

Smoking makes the skin age faster. This leads to wrinkles like "crow's feet" around the eyes and "cobblestone wrinkles" on the neck. This happens because smoking reduces blood flow, limiting oxygen to the skin, and damages collagen, which keeps skin elastic.

Nodular Elastosis

This condition, also known as "Favre–Racouchot syndrome," causes blackheads and wrinkles, especially around the eyes and temples. It is made worse by both sun exposure and heavy smoking. The skin becomes discolored with visible nodules and wrinkles.

Facial Wrinkling and COPD

A study published in Thorax 2006 found a connection between wrinkles on the face and COPD, a lung disease. It's thought that smoking affects both the skin and lungs through similar processes. If doctors notice signs like "crow's feet" on a smoker's face, they might recommend tests for COPD. This early detection can help people get treatment sooner and improve their lung health.

Mumbaikars are currently being forced to wade through waterlogged streets, as the city has been receiving heavy rainfall for the last few days.

Floodwater often gets mixed with harmful contaminants like animal waste, animal feces, waste from human settlements, industrial pollutants, and harmful microorganisms, which can lead to serious monsoon infections.

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Here’s how one can stay safe after getting exposed to floodwater:

Precautionary Measures After Walking Through Floodwater

HealthandMe spoke to Dr. Murtaza S Bagwala, Head of Emergency Medical Services, Saifee Hospital, Mumbai, about how to keep infections at bay after coming in contact with filthy floodwater.

Pay Close Attention To Your Feet And Legs, Even If They Don't Hurt

When you are in floodwater, there may be sharp objects like broken glass, nails, stones and metal debris around you. You are more likely to come in contact with these objects unintentionally.

Dr. Bagwala recommends, “Small cuts, blisters, or punctures may not be noticed but can lead to infection if bacteria get into the skin. If you see any injury, clean it well, brush on antiseptics and consult a doctor for advice if the wound is deep or dirty.”

Also read: World Zoonoses Day 2026: Monsoon Season And The Rise Of Zoonotic Diseases

Don't Overlook Body Aches Or Fever In The Following Days

As the risk of contracting infections is high during monsoon, do not neglect if you develop flu-like symptoms after coming in contact with contaminated floodwater. The expert warns against dangerous monsoon infections like leptospirosis.

He says, “After contact with water contaminated with the urine of an infected animal (usually a rodent), the early symptoms of leptospirosis may include fever, severe muscle pain, headache, vomiting, chills, or redness of the eyes. The symptoms are very similar to those of a viral disease, so prompt medical evaluation is crucial to avoid complications, such as kidney, liver, or lung involvement.”

Don't Ignore Skin Changes

The doctor also says that if your skin’s colour or texture changes after getting exposed to floodwater, do not ignore it. He says that if the area around the feet or legs becomes red, swollen, painful, warm, discharges pus or the itching persists, it should be treated immediately.

These can be signs of bacterial or fungal infections that need to be treated, especially in individuals with diabetes, poor blood flow, or impaired immune function.

Also read: Leptospirosis In Monsoon: Expert Explains Why Early Detection & Prevention Is A Must

Determine If Your Tetanus Shots Are Updated

As you can get cuts and bruises after walking through floodwater, it is important to stay on top of your tetanus shots.

The expert advises, “Seek health care advice if you have a cut or puncture wound, particularly from a sharp object that was submerged in the water, while walking through the water. Early management of wounds can help avoid complications."

Take Precautions When Eating Or Drinking After Exposure

You are also at risk of contracting gastrointestinal infections after coming in contact with floodwater. Contaminated water may enter your mouth and lead to stomach and intestinal infections or may contact food and lead to food poisoning.

Prevent diarrhoea, vomiting and dehydration by drinking only clean, safe water, eating only freshly prepared food and practicing good hand hygiene before eating.

India has approximately 101 million people living with diabetes, one of the largest such populations in the world. Blood sugar levels, HbA1c targets, and medication compliance tend to dominate the clinical conversation around the condition. What receives considerably less attention, from both doctors and patients, is what diabetes does to the feet, and what the consequences of that neglect look like over time.

How Diabetic Foot Ulcers Develop

Diabetic foot ulcers develop when nerve damage caused by prolonged high blood sugar, referred to as diabetic neuropathy, reduces sensation in the feet. A small cut, blister, or pressure sore that a person without neuropathy would notice and address goes unfelt. In the absence of pain as a warning signal, the injury progresses. Infection sets in. By the time the patient presents for medical attention, the wound has often reached a stage where conservative management is no longer sufficient.

The High Cost of Delayed Treatment

The clinical outcomes associated with delayed presentation are sobering. A 2024 study published in Diabetes and Metabolic Syndrome, drawing on real-world data from a tertiary care facility in India, found that amputation was required in 43.4 percent of diabetic foot ulcer patients. Ten-year mortality among those who underwent amputation reached 30.9 percent, compared to 24.5 percent among those who achieved primary healing.

A 2025 cross-sectional study published in Cureus found a significant disparity in mortality rates between individuals with diabetic foot ulcers and those with diabetes alone, at 231 deaths per 1,000 person-years compared to 182. Globally, 18.6 million individuals develop diabetic foot ulcers annually.

Prevention Requires Daily Foot Care

The gap between the clinical evidence on diabetic foot complications and the attention the condition receives in routine diabetes management is where the preventable harm accumulates. Most patients presenting with advanced diabetic foot disease describe a history of minor symptoms that were attributed to something else, ignored, or left unaddressed because they were painless.

Regular foot inspection, appropriate footwear, avoidance of barefoot walking, and early medical review of even minor foot injuries are the practices that interrupt this progression before it reaches the point of irreversibility. Dedicated foot care clinics are built around exactly this philosophy, bringing together the multidisciplinary expertise needed to catch complications early and treat them before the window for limb salvage closes.

Why Multidisciplinary Care Matters

Eastern India carries a significant share of this burden, with patients across West Bengal, Bihar, Odisha, Jharkhand, and the Northeast frequently facing limited access to the multidisciplinary care that diabetic foot management requires. Diabetologists, vascular specialists, wound care experts, reconstructive surgeons, and rehabilitation teams working in coordination produce outcomes that sequential, single-specialty care cannot consistently achieve. Where such integrated care is available and accessed early, limb salvage rates improve, and amputations are reduced.

The Ministry of Health and Family Welfare’s recent advisory on diabetic foot care reinforces that foot health in diabetes management warrants systematic attention, not as an afterthought to glycemic control, but alongside it.

(Dr. Anupam Golash, Consultant - Plastic Reconstructive Surgery, CK Birla Hospitals, CMRI)

A small implanted device that stimulates the vagus nerve may offer substantial and lasting relief for people with severe treatment-resistant depression, according to a large multicenter clinical trial.

The findings, published in the International Journal of Neuropsychopharmacology, showed that improvements in depressive symptoms, quality of life, and daily functioning were sustained for at least two years in most patients who responded to treatment.

Notably, more than 20% of treated participants (39 patients) were in remission after two years, meaning their depressive symptoms had improved enough for them to function normally in daily life.

"We were shocked that one in five patients was effectively without depressive symptoms at the end of two years," said lead author Charles Conway, professor of psychiatry and director of Washington University's Treatment Resistant Mood Disorders Center.

Depression Remains A Major Health Burden

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Earlier this week, Republican Tom Kean Jr. revealed that he had been diagnosed with depression, explaining his absence from public life for more than 100 days.

He is far from alone. About 20% of U.S. adults experience major depression during their lifetime. While most people improve after antidepressants or psychotherapy, up to one-third develop treatment-resistant depression, in which standard treatments fail to provide adequate relief.

Study Focused on the Most Severe Cases

The RECOVER trial, led by researchers at Washington University School of Medicine in St. Louis, enrolled nearly 500 patients across 84 sites in the US. On average, participants had:

• Lived with depression for 29 years
• Tried 13 unsuccessful treatments
• Undergone therapies including electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS)
• Three-quarters were too ill to work.

"We believe the sample in this trial represents the sickest treatment-resistant depressed patient sample ever studied in a clinical trial," Conway said.

"There is a dire need to find effective treatments for these patients, who often have no other options. With this kind of chronic, disabling illness, even a partial response to treatment is life-altering, and with vagus nerve stimulation, we're seeing that benefit is lasting," he added.

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Benefits Lasted for Two Years

The VNS Therapy System, manufactured by LivaNova USA, Inc., involves implanting a small device beneath the skin of the chest. The device delivers carefully calibrated electrical pulses to the left vagus nerve, which serves as a major communication pathway between the brain and internal organs.

Although every participant received an implant, only half had their devices activated during the first year, allowing researchers to compare outcomes.

The latest analysis focused on 214 patients whose devices were activated from the beginning of the study.

Among them:

• About 69% (147 patients) achieved a meaningful improvement in at least one outcome after 12 months.
• More than 80% of those responders maintained or improved those benefits after 24 months.
• Among patients with a substantial response after one year, 92% continued to experience benefits two years later.

Conway noted that even a 30% improvement can dramatically change the lives of patients with severe depression, who often struggle to carry out basic daily activities and face a higher risk of hospitalization or early death.

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Some Patients Improved Later

The study also found that recovery may take longer for some people.

Nearly one-third of participants who had not responded after the first year reported meaningful improvements by the end of the second year, suggesting prolonged stimulation may continue to produce benefits.

Researchers also observed consistently low relapse rates among patients who improved, particularly among those with the strongest responses.