Twin B smoked a half a pack a day for 14 years.  The entire body is affected.   Some of the chemicals in tobacco smoke damage collagen and elastin in the skin.  The damage to collagen and elastin contribute to sagging breasts, and lack of firmness of underarms and other parts of the body.   Age spots and darkening of the skin also are accelerated.   Smokers are twice as likely to lose teeth because of gum disease.  Smoking is a clear risk factor for male-pattern baldness.  Smokers are more likely to develop macular degeneration (the major cause of adult blindness) and cataracts; also osteoporosis, psoriasis.  It is a risk factor for psoriasis.  Long-term smoking of a pack a day or more increases the risk of dying from cancer of the directly exposed tissues by 9.4 times; indirectly exposed tissues by 1.7 times.  However, though it increases the death from cardiovascular disease only 2.1 times, because cardiovascular disease accounts for nearly 75% of all deaths, this increase entails that the excess deaths attributed to smoking are greater from cardiovascular disease than from cancer.  The deadly cardiovascular effect is primarily brought about through oxidative damage to low-density lipoprotein, LDL, (the principle cause being carbon monoxide from incomplete combustion).  White blood cells which attempt to scavenge the LDL, and in the process emit a polypeptide which stimulates the process of plaque formation.  This process leads in long-term smokers to atherosclerosis, the principle cause of heart attacks and strokes--and also erectile dysfunction.   Smoking in woman is significantly associated with fertility problems, miscarriages, premature births, and low-weight infants.  Women experience menopause an average of 1.5 years earlier than nonsmokers. Smokers have twice the rate of bronchitis and phenomena.   And the list goes on, including the second most common form of