Cigarette smoking has been associated with significant morbidity affecting all systems of the body including skin. Body weight concerns and negative body image are also related with cigarette smoking, particularly among young females. To evaluate the impact of smoking behavior on body image and skin care behavior in Korean female college students, Korean female college students (n=516, aged 19-29 years) completed a battery of questionnaires regarding satisfaction with appearance, smoking and drinking behavior, subjective dissatisfaction about skin condition and skin care behavior. The satisfaction with appearance was measured with Satisfaction with Appearance (SWAP) scale. Statistical analyses were performed using PASW Statistics, version 18 (SPSS Inc.).A total of 516 female college students completed the questionnaires. Among the students, 56 students (10.9%) were current smokers, 42 students (8.1%) were ex-smokers, and 418 (81.0%) students replied that they never smoked. Students answered that they were most concerned about acne (n=239, 46.3%), pigmentation (n=143, 27.7%), sensitive skin (n=90, 17.4%) and wrinkle (n=32, 6.2%). Only 2.3% female students answered that they were not concerned about their skin at all and were satisfied with their skin condition. Smoking status (p=.027), body mass index (BMI, p=.000) and skin care behavior (p=.007) were significantly associated with appearance satisfaction by simple logistic regression analysis. Results of multiple logistic regression analysis showed that appearance satisfaction was significantly associated with BMI (p=.000, 95% CI: 0.381-0.911) and skin care behaviour (p=.004, 95% CI: 0.624-3.358). Smokers were significantly dissatisfied with their appearance (p=.027) in total SWAP score. BMI was strongly associated with appearance satisfaction (overall appearance, p=.000). Smoking positively correlated to BMI in female college students (p=.009).Current smokers were more concerned about pigmentation (n=19, 34%) than never smoked (n=112, 27%) and ex-smokers (n=12, 29%). Smokers used more makeup products to cover their skin such as foundation (p=.003) and powder (p=.006) and used less protective sunscreen than never smoked (p=.024). We found significant results confirming association among smoking behavior, appearance satisfaction and BMI in female college students. Smoking female college students with higher BMI are more dissatisfied with their appearance and thus used more makeup products to cover their skin and used less protective sunscreen.