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Finally, CS may worsen NAFLD by enhancing proinflammatory cytokines, such as tumor necrosis factor alpha, that are known to play a key role in NAFLD8.25-27 Although two studies did not find an association between CS and the presence of NAFLD in the general population28,29 only one published clinical study has looked at the possible effect of CS in patients already identified as having NAFLD.30 In that study, CS exposure was associated with increased ALT

Implications for research We know that the more years spent not smoking, the better our health outcomes, but what is the difference in terms of ongoing risk to health for someone who smoked 30 cigarettes per day for 20 years, but quit ten years ago, compared to someone who smoked five cigarettes per day for 20 years, but hasnt quit

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Pack years are a unit of measurement used to estimate the amount a person has smoked over their lifetime