What Smoking and Vaping Do to a Fatty Liver (MASLD)

When we think about liver health, smoking isn’t usually the first culprit that comes to mind.

But smoking and vaping are highly detrimental to a fatty liver. Both introduce toxins into our bodies, toxins that cause oxidative stress, worsen insulin resistance, and accelerate liver scarring in those with MASLD.

Even passive smoking increases the risks for fatty liver, due to the plethora of chemicals and unhealthy elements contained in the cigarette smoke.

In this article, we’ll go in-depth on how these habits affect fatty liver disease and why quitting might be one of the best decisions you make for your health.

Smoking has been frowned upon for years now and fortunately more and more people manage to quit this nasty habit… but there are still many who find it relaxing and enjoy smoking on a daily basis. Or just find it difficult to quit. (Similar to how hard it is to stop eating sugar).

Just when we thought smoking was on the decline, vaping swooped in like the plot twist no one asked for. While it’s marketed as a “healthier” alternative, vaping isn’t doing your liver any favors! Both traditional cigarettes and e-cigarettes are detrimental to your overall health, including liver function.

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If you’re short on time, here’s the bottom line: Quitting smoking or vaping now can significantly improve your chances of reversing fatty liver disease. It’s as easy as that!

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I used to be a smoker as well, but fortunately managed to quit over 15 years ago, and while it wasn’t easy, it wasn’t incredibly difficult either once I fully understood that my well-being and overall health were on the line. So use that as motivation for yourself to stop smoking ASAP.

Now, let’s look closer at the medical facts – as well as my personal experience on the matter – and learn exactly how smoking or vaping connects to fatty liver disease.

Does smoking affect your liver / MASLD (NAFLD)?

Yes, smoking is associated with the development and progression of non-alcoholic fatty liver disease (MASLD, formerly NAFLD). For example, those who smoked for more than 20 years can have up to 36% higher chances of developing a fatty liver and complications.

This was the finding of a study made on 200,000 adults in South Korea, so we can agree that it was pretty extensive. You can read the full study for all the medical data here.

Another interesting study that collected data from 20 other studies made on the matter found that passive smokers are actually at an even higher risk of developing fatty liver than active smokers are.

Which is kind of scary, meaning that even if you don’t smoke, but spend time near a smoker, you are at greater risk of developing a fatty liver.

Why is this happening? The toxins in cigarette smoke – like nicotine, tar, and other chemicals – can lead to inflammation and oxidative stress in the liver. This not only contributes to the development of MASLD but also accelerates its progression.

The conclusion is pretty obvious, in my opinion: smoking is bad for the liver and increases the chances of developing MASLD, while also increasing its progression in those who already have it.

Also read: How to Stay Motivated to Lose Weight and Reverse MASLD.

Does Vaping Affect Those with Fatty Liver Disease?

It seems that e-cigarettes are everywhere now and many people switch to vaping thinking they are making a better choice, mainly by cutting out tar.

While there is logic behind this reasoning, e-cigarettes still deliver concentrated nicotine alongside heavy metals, propylene glycol, and artificial flavorings – compounds that your liver still has to metabolize.

When it processes these chemicals, it triggers the same oxidative stress we see with traditional cigarettes. Nicotine also constricts your blood vessels and drives insulin resistance, which we will cover in a moment.

So no, vaping is not a safe loophole for your liver either!

Should you stop smoking if you have a fatty liver?

Based on the studies presented above, it is clear that it is indeed a good idea to stop smoking if you have been diagnosed with a fatty liver.

The sooner, the better, as the number of years you spend smoking also seems to be associated with increased risks.

Even though we might believe that it’s just the lungs that are affected by cigarettes, that’s not true, although probably our lungs are the ones that suffer the most. It’s similar to another thing that might seem harmless, but it’s not – juicing with MASLD.

The cigarette smoke that we inhale (as active or passive smokers) is filled with toxins, and since the liver is responsible for removing most toxins from our bodies, you can easily see why the two are connected.

The consensus in the medical world seems to be that indeed even a few cigarettes per day can do a lot of harm to a liver that’s already suffering.

One of the studies that I came upon dates from 2010 and was only made on rats. (You can read more about this study here).

It proved that obese rats suffering from fatty liver who were exposed to cigarette smoke (2 cigarettes per day, 5 days per week for 4 weeks) showed an increase in severity of their NAFLD.

The study concluded: “Cigarette Smoke causes oxidative stress and worsens the severity of NAFLD in obese rats. Further studies should assess whether this finding also occurs in patients with obesity and NAFLD.“

Various other medical sources claim that smoking is bad for our livers and can cause a fatty liver to worsen. I would go as far as placing it on the same level as alcohol. And it is clear that you should stop drinking alcohol if you have fatty liver disease.

Taking Action

The bottom line is this: If you’re a smoker or vaper, consider this your sign to quit. Not just for your lungs or heart, but for your liver, too.

And if you’re spending time around smokers, it might be worth encouraging them to quit – not just for their health but for yours as well. If not possible, at least try to spend as little time as possible around them when they smoke.

Why is smoking bad for the liver?

My original assumption, that the toxins from the smoke inhaled from cigarettes pass through the liver, therefore adding extra stress and harming it more is confirmed by experts in the field as well. The biological mechanics go slightly deeper than that, however.

Toxins Overload

Your liver’s main job is to filter out toxins from the blood. When you smoke, you are introducing a cocktail of harmful substances like nicotine, tar, and carbon monoxide into your system (and various other bad things if you are vaping).

This overloads your liver, making it work overtime and potentially leading to inflammation and scarring.

Insulin Resistance

This is the biggest biological link between smoking and fatty liver that many people miss.

Smoking drives fat to your abdominal area (visceral fat) and makes your body resistant to insulin, and insulin resistance is considered one of the main drivers of MASLD, by actively forcing your liver to store extra fat.

Nicotine and Fat Levels

Nicotine doesn’t just mess with your nerves; it affects your blood vessels, causing them to constrict.

This leads to higher blood pressure and increased levels of fats (lipids) in your bloodstream. An excess of these fats can accumulate in the liver, worsening fatty liver disease.

Cholesterol Imbalance

A compromised liver struggles to manage cholesterol effectively. Smoking exacerbates this by disrupting the balance between good (HDL) and bad (LDL) cholesterol.

The imbalance can accelerate liver damage and increase the risk of cardiovascular diseases.

Finally, it is known that smoking has a carcinogenic effect and even though I wasn’t able to find any studies linking smoking – or its carcinogenic effects – to the liver itself, I believe that it’s always better to play it safe and consider the worst.

And remember: since your liver is already sick, it is more sensitive to harmful substances and behaviors than a healthy one is!

Some people claim that smoking helps them to lose weight, and this is what prevents them from stopping, but even if true, it still won’t beat a healthy and balanced diet. So that excuse shouldn’t work here!

Smoking also drains your energy and makes it difficult for you to keep exercising. Since you need to add exercising to your new lifestyle, after being diagnosed, in order to regain health, cigarettes will make things more difficult for you.

Also read: Is Zucchini Good for Fatty Liver?

Wrapping Up

Your liver is an incredible organ with the ability to heal itself, but it can’t do it alone. By quitting smoking, you’re giving your liver the support it needs to recover from fatty liver disease.

Since I did smoke in the past and managed to quit, I know how difficult it is to stop.

But I can assure you that once you get past that horrible initial phase of withdrawal – which lasts for 2 to 4 weeks – you will be so happy with yourself for managing to quit harming yourself by smoking.

You will feel much, much better in all areas and you will see immediate improvements in your overall health.

Plus, it probably helps you a lot in your fight to reverse fatty liver, so it’s a win on all fronts.

It is difficult, I know, but it has to be done! You are strong enough to do it so don’t waste time and just stop! For your health. For your happiness. For giving you a lot more time to spend with your loved ones!

And I guess this answers the burning question in the title: Yes, smoking is bad for fatty liver (and general health) so you should stop ASAP. I managed to do it, many others did it as well, so it is possible. Actually, scratch that. It’s mandatory!

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