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It also increases the breakdown of fat in adipose tissue, leading to more free fatty acids being delivered to the liver whilst potentially impairing the liver's ability to export fat, creating conditions that favour hepatic steatosis

Tests to exclude other causes of liver diseasesuch as viral hepatitis serology, autoimmune markers, ferritin and iron studies, and coeliac screeningmay also be performed

Smoking hazards: Cigarettes, vaping, marijuana

Tobacco use may accelerate progression from simple steatosis to more serious conditions including inflammation, fibrosis, and cirrhosis

Current UK guidance from NICE does not specifically list smokeless tobacco as a primary cause of NAFLD, though tobacco cessation is recommended as part of overall liver health strategies