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These are from older studies but are still relevant.
NEW YORK (Reuters Health) Nov 19, 2008 – There appears to be a synergistic link between smoking and hepatitis C virus (HCV) infection, leading to a more than 136-fold increased risk of hepatocellular carcinoma (HCC) in men, according to a team at The University of Texas MD Anderson Cancer Center.
Dr. Manal M. Hassan and colleagues in Houston also found a link between HCV, heavy alcohol consumption and HCC in women.
Dr. Hassan’s team conducted a case-control study of 319 HCC patients and 1,061 healthy controls to evaluate the effects of active and passive smoking on risk factors for HCC in men and women.
The use of smokeless tobacco, cigars and pipes, and passive smoking exposure were not related to HCC among noncigarette smokers.
However, regular cigarette smoking was associated with HCC in men, with an adjusted odds ratio (AOR) of 1.9. Heavy alcohol consumption was associated with HCC in women, with an AOR of 7.7.
Co-infection with HCV increased risk of HCC exponentially. “Cigarette smoking interacted synergistically with chronic infection of hepatitis C virus in men,” Dr. Hassan’s team reports in the October 15 International Journal of Cancer. They found an AOR of 136.3 for HCC for male smokers with HCV infection.
Women chronically infected with HCV who were heavy drinkers had an AOR of 13.7 for HCC.
“We conclude that sex differences were observed in HCC’s relationship with cigarette smoking and alcohol consumption,” the authors write. “Controlling smoking exposure might be a prudent approach to the prevention of HCC, especially in patients with chronic viral hepatitis infections.”
Int J Cancer 2008;123:1883-1891.
Another study in the Scandinavian Journal of Gastroenterology, “Smoking and risk of liver cirrhosis: a population-based cohort study, from 2013,” assessed the independent effect of smoking on alcoholic liver cirrhosis and liver cirrhosis in general. The authors concluded that smoking was associated with an increased risk of liver cirrhosis independent of alcohol intake.
See also this excellent article by Nicole Cutler: Smoking with Hepatitis C Raises Liver Cancer Risk