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Observational studies show tobacco users have higher rates of non-alcoholic fatty liver disease compared to non-users, even after adjusting for other risk factors

NAFLD is not the only type of liver disease smoking affects, however

Fatty liver from alcohol (alcohol-related liver disease) results directly from excessive alcohol consumption, whilst tobacco-related effects contribute to non-alcoholic fatty liver disease through metabolic pathways involving insulin resistance and inflammation

[11] Additionally, tobacco products contain numerous toxic compounds beyond nicotine, including nitrosamines and heavy metals, which may exert direct harmful effects on the liver