The fashion industry was blamed yesterday for glamorising smoking, despite medical evidence which shows it hastens the onset of wrinkles and signs of old age.

The fashion industry was blamed yesterday for glamorising smoking, despite medical evidence which shows it hastens the onset of wrinkles and signs of old age.

Professor Sir Liam Donaldson, the Government's chief medical officer, accused the industry of deceiving the public by linking smoking cigarettes with beauty when the truth was that it destroyed the skin and made people look prematurely old.

"The tobacco industry is very good at using fashion, glamour and success as a hot button to promote its products. We should use skin ageing as a hot button on the health front," he said.

Displaying a series of photos of models smoking, he said: "They are a highly successful form of self-deception. They build up the myth that smoking gives you access to a dream of social success and advancement."

Yet the reality was that smoking destroyed the skin by degrading collagen and damaging the tiny blood vessels that feed it. He added: "Many people are aware smoking causes premature death and serious diseases like heart disease and cancer. Few know smoking prematurely ages the skin. [Yet] people will often observe smokers look a lot older than their years, and the changes are irreversible."

Sir Liam was speaking at the launch of his annual report on the state of public health. He raised the stakes in the battle to ban smoking in public by challenging ministers for the second time to take action towards a ban, which he said would reduce the number of young people taking up smoking and save hundreds of thousands of lives.

He said pubs, clubs and restaurants had boomed in Ireland and the US, where a ban was in place. Annual savings from a ban would be £2.3bn to £2.7bn, according to an economic analysis commissioned for the report - leaving the only counter-argument as the defence of smokers' rights.

John Reid, the Health Secretary, is known to be opposed to a ban, and favours voluntary measures to create smoke-free areas in bars and restaurants. Sir Liam said he disagreed with Mr Reid, but remained hopeful that he would change his mind. He said he had no plans to resign over the issue because of positive feedback from politicians.

His comments were welcomed by the anti-smoking lobby. Professor Rod Griffiths, the president of the Faculty of Public Health, said: "The truth is finally out. Smokers don't grow old, they just look old."

The British Medical Association said: "It is time for ministers to show leadership, and follow the example of Ireland, Norway and New York."

The report also highlighted the risks posed by the growing number of people with undetected HIV. One-third of people with HIV do not know they are infected, and the average time to detection was more than six years, Sir Liam said. He ruled out compulsory HIV screening, but said clinics should do more to encourage patients to have tests.

Sir Liam also raised concerns about the safety of blood transfusions after a 21 per cent rise last year in incidents in which the "wrong" blood was given. Blood donation had fallen 20 per cent since 1999 as a result of new restrictions to protect the blood supply against diseases such as variant CJD, but greater care was needed over its use.

The report also highlighted the crisis in academic medicine, with applicants for research posts down by a third since 2000.

Andrew Lansley, the Tory health spokesman, criticised the report for failing to mention the hospital infection MRSA.

"With thousands of people still dying every year, and the damning revelation from the National Audit Office that government targets are preventing the implementation of infection control measures, it is highly surprising that it was not included."

Mr Lansley said the report exposed the Government's failure to tackle the causes of ill-health. "It is vital that Labour's politically set hospital-based targets are abolished," he said.