Introduction: Acne is a common problem in adolescent and youngage groups, for which several risk factors have been suggested.One of the risk factors is smoking. In studies on the relationshipbetween smoking and acne, conflicting results have been obtained.Method: This study was conducted on 133 male patients whowere visited at the dermatology clinic of Imam Reza hospital dueto acne as the case group, and 133 healthy individuals withoutany skin diseases including acne among those accompanying thepatients as the control group. The case and the control groups wereage matched. For each patient who had the criteria for inclusionin the study, a questionnaire was completed and the necessaryinformation was collected and then analyzed statistically.Result: The questionnaires were filled for 133 patients with acneand 133 healthy controls. Twenty-nine patients with acne (21.8%)and 12 patients in the control group (9.1%) were smokers, and thedifference between them was significant (P = 0.004). The numberof cigarettes smoked per day was significantly different in thetwo groups (4.75 in the case group versus 1.88 in the controlgroup). No correlation was found between smoking and acnelocalization, severity of acne, the type of lesion, symptomaticor asymptomatic nature of acne and acne complications. In thecase group, the smokers developed acne at an older age thanthe non-smokers.Conclusion: Patients with acne were more likely to smoke thanpatients without acne; thus, smoking might be a factor affectingthe incidence of acne.