Impact of smoking on melanoma prognosis and survival

Cigarette smoking is a well-established risk factor for multiple malignancies; however, its association with melanoma remains unclear and, in some cases, paradoxical. While several epidemiological studies have reported no significant increase in melanoma incidence among smokers, others have suggested a potential inverse relationship, likely influenced by confounding factors such as detection bias and competing mortality risks. Despite these inconsistencies in incidence, emerging evidence indicates that smoking may adversely affect melanoma progression and patient outcomes. Proposed mechanisms include oxidative stress-induced DNA damage, smoking-related immunosuppression, and interactions with ultraviolet radiation, all of which may contribute to tumor development and progression. Clinically, smoking has been associated with increased tumor aggressiveness, higher metastatic potential, and reduced survival. This mini-review summarizes current evidence on the relationship between cigarette smoking and melanoma, highlighting epidemiological findings, underlying biological mechanisms, and implications for prognosis and clinical practice.