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However, its impact on liver health is often overlooked

Evidence suggests multiple interrelated pathways of liver injury: Nicotine-induced injury : Nicotine is metabolized in the liver via CYP2A6, where it activates 7-nicotinic acetylcholine receptors (7-nAChR), leading to oxidative stress, mitochondrial dysfunction, and pro-fibrotic signaling [36, 125, 126]

"The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences"

Whilst the cardiovascular and oral cancer risks of chewing tobacco are well-established, the relationship between smokeless tobacco use and fatty liver disease represents an emerging area of research

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[40] Usage was more common among males (15.0%) than females (2.2%) and among Whites (11.9%) than Blacks (3.3%) or Hispanics (5.1%)