A new research review published in Clinical and Experimental Medicine suggests that smoking cigarettes is a significant risk factor for a broad range of liver diseases, including primary biliary cholangitis (PBC).
The review, which draws on decades of epidemiological and clinical research, found that people who have ever smoked have a higher risk of developing PBC than those who have never smoked cigarettes.
While PBC already has well-known autoimmune and genetic risk factors, smoking seems to add another layer of risk, researchers say. They suggest that toxins in cigarette smoke may fuel immune system changes that make it more likely for the body to attack the small bile ducts in the liver.
Learn more about PBC causes and risk factors
Evidence also indicates that among individuals living with PBC, smoking is associated with accelerated disease progression and more severe liver damage. In some studies, the risk of significant fibrosis was several times higher in PBC patients who smoked compared with those who didn’t.
The review outlines several mechanisms through which tobacco smoke may worsen liver disease, including oxidative stress, immune dysregulation and chronic inflammation. These processes may accelerate bile duct destruction and scarring, which are both central features of PBC.
Beyond PBC, the review emphasizes that smoking adversely affects virtually all major types of chronic liver disease, including metabolic-fatty liver disease, alcohol-related liver disease, chronic hepatitis and liver cancer.
The authors advocate for smoking cessation as a critical, yet often under-appreciated component of liver-disease management and prevention.
“By integrating the updated research data and clinical insights, this review aims to underscore the urgent need for greater awareness among healthcare professionals and patients regarding the profound and pervasive link between smoking and liver disease, advocating for targeted interventions to alleviate this preventable burden,” the researchers concluded.
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