Cigarette smoking and liver diseases

Marti-Aguado, David; Clemente-Sanchez, Ana; Bataller, Ramon

doi:10.1016/j.jhep.2022.01.016

Cited by 191Smoking Behavior and CessationLiver Disease Diagnosis and TreatmentAlcohol Consumption and Health Effects

Cigarette smoking and liver diseases

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Marti-Aguado, David, Clemente-Sanchez, Ana, Bataller, Ramon·2022·Journal of Hepatology

DOI 10.1016/j.jhep.2022.01.016

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Abstract

Cigarette smoking is a preventable risk factor for premature morbidity and mortality. A history of smoking is observed in approximately 40% of patients with liver disease, while a growing number of studies are investigating the potential impact of smoking in chronic liver diseases. This review discusses the effects of smoking on liver diseases, at multiple levels, with a focus on its potential causal role. Clinical evidence indicates that cigarette smoking negatively impacts the incidence and severity of fatty liver disease, fibrosis progression, hepatocellular carcinoma development, and the outcomes of patients with advanced liver disease. The underlying mechanisms are complex and involve different pathophysiological pathways including oxidative stress and oncogenic signals. Importantly, smoking promotes cardiovascular disease and extrahepatic cancers in patients with steatohepatitis and in transplant recipients. We discuss how promoting smoking cessation could improve the rates of treatment response (in clinical trials) and fibrosis regression, while reducing the risk of hepatocellular carcinoma and improving liver transplant outcomes. Finally, we discuss current challenges such as the referral of smokers to specialised units for smoking cessation.

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There is evidence that smoking is related to MASLD, liver fibrosis and liver cancer.
“There is evidence that smoking is related to MASLD, liver fi brosis and liver cancer.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [113]

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Authors: Marti-Aguado, D., Clemente-Sanchez, A., & Bataller, R.
Affiliations: University of Pittsburgh Medical Center (US)
Corresponding author: Bataller, Ramon
ORCID: Marti-Aguado, David
Clemente-Sanchez, Ana
Bataller, Ramon
Venue: Journal of Hepatology
Publisher: Elsevier BV
Published: 2022-07
Volume: 77
Issue: 1
Pages: 191-205
ISSN: 0168-8278 (ISSN-L)
DOI: 10.1016/j.jhep.2022.01.016
OpenAlex: W4210795703
Cited by: 190
References: 147
Citations by year: 2026: 33 · 2025: 67 · 2024: 60 · 2023: 24 · 2022: 6
FWCI: 5.40
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (am, 349 d)
Locations: Journal of Hepatology (acceptedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Institute on Alcohol Abuse and Alcoholism (1U01AA026264-01, 1U01AA026972-01, 1U01AA026978-01, RO1AA018873)
National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK117881-01)
Asociación Española para el Estudio del Hígado
Instituto de Salud Carlos III
Ministerio de Ciencia e Innovación
Topics: Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords: cigarette smoking, chronic liver disease, hepatic steatosis, liver fibrosis, hepatocellular carcinoma, steatohepatitis, oxidative stress, oncogenic signaling, smoking cessation, liver transplantation, cardiovascular disease, extrahepatic cancer, fibrosis regression
MeSH terms: Cigarette Smoking, Cardiovascular Diseases, Fibrosis, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Risk Factors, Smoking

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