Cigarette smoking and alcohol-related liver disease

Abstract

China is a major consumer of alcohol and tobacco. Tobacco and alcohol use are closely linked, with up to 90% of alcoholics having a history of tobacco use, and heavy smokers also tending to be alcoholics. Alcohol-related liver disease (ALD), one of the most common and serious complications of chronic alcohol intake, involving hepatic steatosis, hepatitis, hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC), has become one of the globally prevalent chronic diseases. An increasing number of studies have focused on the association between smoking and ALD and explored the mechanisms involved. Clinical evidence suggests that smoking has a negative impact on the incidence and severity of fatty liver disease, progression of liver fibrosis, development of HCC, prognosis of patients with advanced liver disease, and alcohol-related liver transplant recipients. The underlying mechanisms are complex and involve different pathophysiological pathways, including free radical exposure, endoplasmic reticulum stress, insulin resistance, and oncogenic signaling. This review discusses the deleterious effects of smoking on ALD patients and the possible underlying mechanisms at several levels. It emphasizes the importance of discouraging smoking among ALD patients. Finally, the pathogenic role of electronic cigarettes, which have emerged in recent years, is discussed, calling for an emphasis on social missions for young people.

Keywords

Cigarette smoking (CS) / Alcohol-related liver disease (ALD) / Electronic cigarettes (E-cigarettes) / Alcoholism / Liver transplantation (LT)

Authors’ contributions

Hui-Min Lin and Jing-Rong Zhang contributed equally to this work and should be considered co-first authors. Hui-Min Lin: Writing e original draft, Data curation, Conceptualization. Jing-Rong Zhang: Writing e original draft, Visualization. Meng-Xue Li: Investigation. Hui Hou: Supervision. Hua Wang: Supervision. Yan Huang: Writing e review & editing, Funding acquisition. All au-thors have read and approved the final version of the manuscript.

Declaration of competing interest

Hua Wang is an editorial board member for Liver Research and was not involved in the editorial review or the decision to publish this article. All authors declare that there are no competing interests.

Acknowledgements

This work was supported by grants from the National Natural Science Foundation of China (82370591), Hefei Natural Science Foundation of China (2023018), Scientific Research Project of Col-leges and Universities of Anhui Province (Natural Science)(2023AH040078) and Anhui Medical University Research Level Improvement Program (2023xkjT010).

Appendix A. Supplementary data

Supplementary data to this article can be found online at https://doi.org/10.1016/j.livres.2024.12.002.

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