Tobacco smoke contains harmful toxins, such as ammonia and hydrogen cyanide, that harm nearly every organ in the body—and the liver is no exception. Recent research published in Frontiers of Public Health highlights the association between smoking status and the incidence of non-alcoholic fatty liver disease (NAFLD), noting that the odds ratio is higher for ex-smokers and current smokers than nonsmokers. Furthermore, the risk of NAFLD was negatively associated with the duration of smoking cessation while being positively associated with the number of pack years.
While it’s clear that smokers can benefit from cessation, how exactly does cigarette smoking affect liver health? Let’s find out below, along with practical ways for smokers to quit and improve their liver health and overall well-being.
Smoking’s effects on the liver
Even if an organ does not have direct contact with cigarette smoke itself, it can still be affected by the release of toxins into the bloodstream. Such is the case with the liver, where free radicals and chemicals with cytotoxic potential can cause oxidative damage to liver cells. Additionally, heavy smoking increases the production of pro-inflammatory cytokines linked to liver cell injury, mainly in the form of necroinflammation, apoptosis or cell death, and excess iron in the liver.
There is also new insight that explains the underlying mechanism between smoking and fatty liver disease, in particular. 2022 research in China published in Nature found that nicotine directly activates a protein called AMPK in the intestines. When activated, AMPK stabilizes another protein called SMPD3, which then yields specialized lipids called ceramides. Smoking causes ceramides to accumulate in the liver and thus promote NAFLD progression. Despite smoking’s long-term damaging effects on the liver, cessation can reverse these through the elevation of immune responses, decrease in pro-inflammatory cytokines, and increase in antioxidant activity.
Ways to quit smoking and improve liver health
Try nicotine alternatives
While the reversal of smoking-induced liver damage can be detectable within a month of cessation, dealing with smoking urges and withdrawal symptoms can be challenging. As such, smokers can try nicotine alternatives to ease the transition into a smoke-free lifestyle. Some popular choices include brands such as Nicorette (gums and lozenges), which are usually found in pharmacies and convenience stores, alongside ZYN (pouches) and Niquitin (patches). Indeed, the ZYN wintergreen pouches sold online on Prilla are a reduced-risk alternative due to their tobacco-free properties. These pouches are designed to mimic the taste of a menthol cigarette but come without the risks associated with lighting up. While nicotine pouches do not contain the liver-damaging toxins from smoking and chewing tobacco, be careful not to ingest them to avoid side effects like stomach discomfort and nausea.
Consider quit-smoking medication
Meanwhile, smokers who prefer to stay free of both tobacco and nicotine during the cessation period can opt for quit-smoking medication. The quit-smoking drug Chantix (varenicline) has been documented to increase cessation rates and decrease relapse by attaching to the nicotine receptors in the brain and making smoking feel less gratifying. Moreover, Chantix has not been linked to any drug-induced cases of liver injury or failure, which means smokers may not have to fear any damage to their liver health while using the drug.
Eat flavonoid-rich foods
On top of pharmacological interventions, smokers can also enhance their diet as a therapeutic strategy to restore liver function. Flavonoids are an example of an antioxidant that may protect against smoking’s damaging effects by inhibiting oxidative stress and inflammatory responses in the liver. The main dietary sources of flavonoids include tea, wine, leafy greens like kale and broccoli, and citrus fruits like oranges and grapefruits.
These strategies can then be combined with behavioral interventions, such as creating a quit plan and going to counseling, for more successful and sustained cessation. Ultimately, the best way to reverse the adverse effects of smoking on the liver and overall health is by quitting the habit as soon as possible.
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