Smoking may be considered a risk factor for disease progression and increased risk of mortality in patients with early-stage cutaneous melanoma, according to a recent study published by Jackson et al in JAMA Network Open. In a post hoc analysis, investigators used data from the MSLT-I and MSLT-II trials to analyze the outcomes of 6,279 patients with stage I or II cutaneous melanoma from January 20, 1994, to March 29, 2022, and December 21, 2004, to March 31, 2014, respectively. The patients were evaluated for current (n = 1,077), former (n = 1,694), and never-smoking (n = 3,508) status. After a median follow-up of 78.4 months, the investigators found that compared with patients who were never-smokers, patients who currently smoked had a heightened risk of lymph node metastases and melanoma-specific mortality (hazard ratio [HR] = 1.48, 95% confidence interval [CI] = 1.26–1.75)—especially those with sentinel lymph node biopsy–negative tumors (HR = 1.85, 95% CI = 1.35–2.52) and those who smoked 20 or more cigarettes per day (HR = 2.06, 95% CI = 1.36–3.13). However, those who formerly smoked were not at an increased risk of mortality. Patients who were younger; male; and who had melanoma on the trunk, thicker tumors, tumor ulceration, and sentinel lymph node biopsy positivity were more likely to currently be smokers. The investigators concluded that physicians should assess patients’ smoking status at the time of melanoma diagnosis.