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.

According to a recent study, the rate of strokes among young adults in the United States has nearly doubled in the last two decades. With risk factors like high blood pressure, diabetes and high cholesterol surfacing years earlier, experts are seeing an increasing number of stroke emergencies under the age 40.

On World Stroke Day, Dr Arup Sen, London-based physician, specialising in geriatric, stroke and General Medicine and affiliated with Cleveland Clinic London, National Hospital for Neurology and Neurosurgery, and University College Hospital, spoke to HealthandMe about the alarming pattern of stroke rates among young people.

The doctor said that recreational drug use, smoking, sedentary behaviour and obesity add to stroke risk, while certain underlying medical conditions could also be triggers.

Dr. Sen said, “The bottom line is that what we refer to as stroke risk factors, the risk factors are arriving decades earlier compared to previously. And that's why we're seeing this surge in stroke rates in young people.”

Recreational Drugs And Steroid Use Fuel Stroke Risk

Dr Sen said recreational drugs affect blood vessels and blood pressure directly, increasing the risk of stroke. Cocaine, for instance, can narrow the blood vessels that could disrupt blood flow to the brain. It can also trigger sudden increases in blood pressure.

“Generally speaking, most substances cause stroke through a mechanism of causing vasospasm and a surge in blood pressure or high blood pressure, which then increases the risk of having a stroke,” he said.

Cannabis use has also been linked to risk of stroke according to some studies. Dr Sen referred to research reporting an association between cannabis use and stroke, including studies examining daily use. He noted that tobacco use can complicate the picture because some people smoke cannabis with tobacco.

“Tobacco itself is a risk factor for stroke. So, for example, people who smoke cigarettes have twice the risk of stroke as someone who doesn't smoke,” he said.

He also warned against combining smoking with vaping, saying that research has associated dual use with a higher stroke risk.

The doctor said that anabolic steroids used for bodybuilding is a major concern. According to Dr Sen, these substances can lead to thickening of the blood which inceases blood clotting risk and affect the structure of the heart. This could lead to abnormal heart rhythms and blood clots.

“One of the most important ways in which you can increase risk is it can make the blood more thick and sticky, increasing risk of blood clots, but it can also affect the heart in terms of causing what we call a cardiomyopathy,” he said.

His advice to people using anabolic steroids for bodybuilding was straightforward. He said, “Don't use them, just avoid them altogether, because if you're using it, there's going to be a risk.”

Also read: 'Humanity Can Still Act': Lancet Warns Of 17 Global Health Threats By 2100

Birth Control And Migraine With Aura Fuel Stroke A Risk In Young Women

Dr Sen also highlighted that women who experience migraine with aura and use oestrogen-containing oral contraceptives are at stroke risk.

Migraine with aura involves neurological symptoms that can occur before or during a migraine attack. According to Dr Sen, the oestrogen component of certain contraceptives can increase the risk of blood clots and stroke in women with this history.

He said, “If a young lady with a history of migraine and aura has a stroke, then we would recommend them, and they're using contraceptives, we would recommend them using progesterone-only contraceptives, avoiding oestrogen, because the oestrogen component is a risk factor for strokes.”

The choice of contraception, however, should be always discussed with a healthcare professional.

Hidden Causes Of Stroke In Younger Adults

Not every stroke in a younger person is explained by conventional risk factors. Dr Sen said doctors investigate conditions that may be more relevant in younger patients, including patent foramen ovale (PFO), antiphospholipid syndrome (APS) and arterial dissection.

A PFO is an opening between the upper chambers of the heart. Dr Sen explained that even though it is common, occurring in around one in four people, in certain cases it can allow a blood clot to pass through the heart and travel to the brain.

Antiphospholipid syndrome is a condition that can increase the tendency to form blood clots. Arterial dissection, meanwhile, involves a tear in the wall of an artery. Dr Sen said it can occur in association with sports or neck manipulation and may initially cause neck pain or headaches before neurological symptoms develop.

He said PFO and arterial dissection were the two most common unusual causes he had encountered in younger stroke patients, followed by antiphospholipid syndrome.

He said, “The most common cause I've seen is PFO, definitely, followed by dissection, and then probably antiphospholipid syndrome.”

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Stroke Symptoms In Young People Can Be Overlooked

Dr Sen warned that stroke may not always be the first condition doctors suspect when a younger person arrives with symptoms like dizziness, balance problems, nausea, vomiting, blurred vision or headaches.

Posterior circulation strokes, which affect the back of the brain, can cause symptoms that resemble other conditions. These may be mistaken for intoxication, gastroenteritis or migraine, potentially delaying diagnosis.

“There's this common myth that stroke, if it happens, it's inevitable. There's nothing you could have done to prevent it. But the opposite is true, because the majority of strokes are actually preventable if you address the risk factors in a proactive fashion,” he said.

How Can Younger Adults Reduce Their Stroke Risk?

Dr Sen urgently recommends addressing lifestyle factors, keeping key health biomarkers in check and recognising stroke symptoms at the earliest.

He advised younger adults to stay physically active, avoid smoking and recreational drugs, maintain a healthy diet, get adequate sleep and avoid binge drinking. He also urged people to monitor their blood pressure, cholesterol and blood glucose rather than assuming these checks are necessary only later in life.

He said, “Know your numbers. By that, I mean, your risk factors. Even in as early as your mid 20s to early 30s, you should be looking at your blood pressure, cholesterol and diabetes markers.

Dr Sen also said that some people may have genetically elevated cholesterol even when they are young. He also mentioned lipoprotein(a), or Lp(a), a largely genetically determined risk factor that is not routinely included in every standard cholesterol assessment.

Finally, he stressed the importance of recognising the signs of stroke through the BEFAST acronym:

• B – Balance: Sudden loss of balance or coordination.
• E – Eyes: Sudden vision loss or double vision.
• F – Face: Drooping on one side of the face.
• A – Arms: Weakness or one arm drifting down.
• S – Speech: Slurred speech or difficulty finding words.
• T – Time: Call emergency services immediately.

“The mantra in stroke that we use is time is brain,” Dr Sen said. “The earlier you get to the hospital and see the specialists and get the right treatment at the right time and the right place, the better the outcomes.”

People with hemophilia face an increased risk of poor bone health due to recurrent joint and muscle bleeds, joint damage and reduced physical activity. Experts told HealthandMe that preventing bleeds from childhood, alongside adequate nutrition, appropriate exercise and regular assessment, can help protect bone health throughout life.

Globally, an estimated 836,000 people have hemophilia, including approximately 284,000 with severe hemophilia. In India, the World Federation of Hemophilia (WFH) reported nearly 28,000 diagnosed and registered patients as of 2026, including more than 24,000 with Hemophilia A. However, the estimated prevalence could be as high as 1,36,000, suggesting many cases remain undiagnosed or misdiagnosed.

Childhood and adolescence are critical for building peak bone mass, making early intervention important for long-term musculoskeletal health, said health experts.

How Hemophilia Can Affect Bone Health

Hemophilia is an inherited bleeding disorder caused by a deficiency of clotting factor VIII (Hemophilia A) or factor IX (Hemophilia B). It primarily affects males, while women are often carriers.

Repeated bleeding into joints can cause chronic pain, joint damage, deformity and reduced mobility. Muscle bleeds can further restrict movement, limiting participation in physical activities that help maintain bone strength.

“Bone health begins in childhood, but protecting it is a lifelong commitment. In people living with hemophilia, recurrent joint and muscle bleeds, reduced physical activity and other risk factors can contribute to poor bone health and an increased risk of osteoporosis,” Dr. Varun Bafna, associate professor in the Department of Hematology at Chhatrapati Shahu Maharaj Government Medical College, Kolhapur, told HealthandMe.

Why Prophylaxis Matters

Prophylaxis involves preventive treatment to reduce bleeding episodes rather than treating bleeds only after they occur. Regular factor prophylaxis can help prevent recurrent joint bleeds, preserve joint function and support mobility.

“Regular factor prophylaxis helps prevent repeated joint bleeds and preserve joint function. That protection can support mobility, an important contributor to bone health,” Dr. Hitha B, associate professor and haematologist in the Department of Medicine at Government Medical College, Kozhikode, told HealthandMe.

She advised patients to discuss breakthrough bleeding or difficulties accessing treatment with their healthcare team so their treatment plan can be reviewed.

Dr. Bafna said consistent prophylaxis can also support muscle strength and safer participation in physical activity.

“Prophylaxis is not just about preventing bleeding today; it is an important part of protecting long-term musculoskeletal health and quality of life at every age,” he noted.

How to Protect Bone Health From Childhood

Experts recommend an individualized approach based on age, joint health, mobility and other risk factors. Key measures include:

• Calcium and vitamin D: Ensure adequate intake through diet and discuss supplementation with a healthcare professional when needed.
• Appropriate physical activity: Weight-bearing exercises suited to individual joint health can help maintain bone strength, with guidance from the care team.
• Physiotherapy: Tailored rehabilitation can help maintain muscle strength, mobility and joint function.
• Regular assessment: Periodic evaluation can identify bone-health concerns and determine whether further investigations are needed.
• Consistent prophylaxis: Adhering to prescribed preventive treatment can reduce bleeding episodes and help protect joints.

A Multidisciplinary Approach to Lifelong Care

Hematologists, physiotherapists and other healthcare professionals can help patients and families integrate preventive treatment, rehabilitation, nutrition and appropriate physical activity into an individualized care plan.

Early intervention and consistent care can help preserve joint function, mobility and quality of life as people with hemophilia grow older.

A stroke rarely announces itself loudly. A sudden wobble, a blurry eye or a slightly lopsided smile is easy to ignore. But in a stroke, minutes decide how much of the brain survives.

On World Stroke Day, doctors want everyone to know one simple tool: BE FAST.

What Doctors Say

Dr. Abhinav Gupta, Director of Neurology at Sarvodaya Hospital, Greater Noida West, and Dr. Atampreet Singh, Senior Director and Head of the Institute of Neurosciences at ShardaCare, Healthcity, told HealthandMe, “Knowing the early warning signs of a stroke can shorten the road to full recovery,” they said.

The problem, they added, is that “a stroke’s symptoms can be easy to dismiss as minor inconveniences, like being tired or having weak muscles.”

What Is BE FAST?

BE FAST was developed by Intermountain Healthcare as an adaptation of the American Stroke Association’s FAST model, according to a Frederick Health handout. The doctors break it down like this:

• B – Balance: “Unsteady feeling or sudden lack of muscle control and dizziness can be a warning sign of a stroke.”
• E – Eyes: “Don’t overlook loss of sight in one or both of a person’s eyes, sudden blurring, or double vision.”
• F – Face: “Ask the person to smile. Unevenness or droopiness on one side of the face can be a sign.”
• A – Arms: “Have the person raise both of their arms. If the person has difficulty holding one arm up or has unusual arm weakness, get emergency help.”
• S – Speech: “Sudden lack of ability to talk, inability to understand what others are saying, or slurred words, can be signs of a stroke.”
• T – Time: “If one of these symptoms occur out of the blue, then call emergency services. When the emergency operators are on the line, let them know what symptoms have presented.”

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Why “Time” Matters The Most

Time is not a symptom. It is a reminder to hurry. Duke Health, citing the American Stroke Association, says to call for help even if the symptoms go away. Weill Cornell Medicine, citing the same group, says never to drive yourself to hospital.

The Frederick Health handout adds that you should note when the symptoms began. UChicago Medicine estimates that about 1.9 million brain cells die every minute in a stroke caused by a large blocked artery.

India’s biggest problem is delay in seeking medical treatment.

An ICMR study of 34,792 stroke cases at 30 hospitals between 2020 and 2022 found that only 5.3% of patients reached hospital within the first hour, according to South First. Nearly four in ten waited more than 24 hours. Down To Earth, reporting on a Lancet Neurology study, says India had over 1.25 million new stroke cases in 2021, up 51% since 1990.

If you see even one sign, don’t wait for the others. Call 112, India’s single emergency number, which also covers the 108 ambulance service, according to Factly. Say what you see and when it began.

Share BE FAST with your family tonight. You may be the one who spots it.