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Cigarette smoking and liver diseases
Open accessAbstract
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 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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Metadata
- Authors
- Marti-Aguado, D., Clemente-Sanchez, A., & Bataller, R.
- Affiliations
- University of Pittsburgh Medical Center (US)
- Corresponding author
- Bataller, Ramon
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2022-07
- Volume
- 77
- Issue
- 1
- Pages
- 191-205
- ISSN
- 0168-8278 (ISSN-L)
- 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
- 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 › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Hepatology › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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