Research published in the Journal Thorax suggests that middle aged smokers with heavily wrinkled face have 5 times more risk of getting chronic obstructive pulmonary disease (COPD) than others.
COPD is an umbrella term for a range of progressive chronic lung diseases, such as emphysema and bronchitis, which block the airways and restrict oxygen flow around the body.
In excess of 1 million people are thought to have COPD in the UK, many of whom have not been diagnosed. And the World Health Organization estimates that it will become the third leading cause of death in the world by 2020.
But not all smokers go on to develop COPD, and the researchers wanted to know if the extent of facial wrinkling might provide a clue as to a smoker's likelihood of having the disease.
They studied 149 current and former middle aged smokers from 78 families. In all, 68 people had COPD.
More than 80% (124) of the total sample had no or very few facial lines, and 25 had widespread wrinkles.
Forced expiratory volume in 1 second, which measures lung strength, was significantly lower in those with extensive wrinkling than it was in those whose faces were only minimally lined.
And those with lined faces were five times more likely to have COPD than those without, after taking account of age and the number of years as a smoker. Facial wrinkling was also associate with triple the risk of more severe emphysema.