PBC Foundation
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Smoking and PBC


This is one of the studies (here conducted by a London doctor) stating that smoking not only favours, but it might also be a trigger and an element of aggravation for liver health generally and PBC particularly.

Passive smoking is also included here. Other writings about Dr Smyk et al. research state that smoking produces complex changes in the immune system and the metabolic processes, enhance the production of free radicals and oxidative stress, and as such is anything but beneficial for an already affected liver.

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Note the above study was published in 2012 (Annals of Hepatology).

The same team advise to quit smoking for the PBC patients' health but for their families' sake as well, as passive smoking can be, next to genetic factors, yet another trigger of PBC in relatives, so -they say- better to spare oneself, as a PBC patient, and one's close ones, of this risk that you can completely control actually.


They have NO IDEA what causes PBC but, lets face it, smoking is never good!

If you're liver is already under attack, it certainly doesn't need extra toxins from alcohol or cigarettes to battle with.


As much as there is no final information about THE causes of PBC, many studies agree that some factors are involved in triggering it, or can be frequently suspected of being triggers. Infections, genetic factors, environmental toxins are among these.


Smoking is bad for anyone whether healthy or not. It's common sense that for someone with a damaged liver or any other organ that can't process toxins etc properly that smoking probably isnt going to help. I'm 25, never even tried a cigarette and have been drunk maybe 10 times since turning 18 with my last drink been August 2010. I think it's just luck of the draw...


Smoking has been linked to PBC before and there is quite a lot of research and evidence that seems to suggest that it might be one of the many 'triggers' - though as people have said, noone knows for sure.

Smoking is bad but, like so many other things, it's hard to beat once you've started I am still trying!


I am not a smoker. But my mother had PBC, died of PBC, I have seen it all how bad it can get to die of PBC, and I believe what everybody, doctors and therapists said - the fact that my mother was a heavy smoker for many decades, though she had quit for a few years before she died, surely and strongly impacted on her evolution.

Sorry, might be rough, but it needs to be said.


Wooow that is tough..... What a reality check, but thanks for your honesty!! I did not realise you could actually die from PBC itself, I was under the impression that it was usually brought about by something else.

Cristina, I am so sorry for the loss of your mum.


From all I know, it happens rarely, most, vast majority of PBC patients die WITH it, not from it. My mom was just one single case. It's up to every person to decide how they manage their PBC and body generally, at the end of the day. Good luck anyway ! :)

(Thank you, is fine now. I have gotten into PBC volunteering and am trying to help others with this condition in my country. You can become a PBCF volunteer as well, if you are in the UK.. or not only, as I am in / from Romania :) )


hmmm not convinced sorry. Most of the people I know with PBC don't smoke and most people I know who do smoke don't have PBC!!!


It is every single person's choice, obviously. There are studies, there are doctors one can ask, but at the end of the day, every person can choose.

Good luck to those who want to quit - btw, hear about Allen Carr's book about this? I know 1 or 2 people for whom it has worked. Of course, they started to read it because they wanted to quit, not because they wanted to prove themselves the book doesn't work ;);)


Not yet read it but have read quite a lot of articles over the years on smoking and passive smoking.

I was raised with 2 parents who both smoked so couldn't avoid being in that atmosphere 24/7.

I became more loathe to smokers when I left home at 18 and got married. My now late first husband was asthmatic and his father smoked and even going to my parents' home along with 2 dogs at the time caused him such discomfort. We didn't allow visitors, even our parents to come to our home and smoke.

My husband now was raised with parents who smoked and like myself he has a chest that isn't in tip-top condition. Since I was a child I have had a sort of barking cough in winter if I developed one which I know was due to my parents smoking. (I have no lung problems as such.)

What really annoys myself and my husband now is the fact I developed this PBC (diagnosed Dec 2010) and as far as we know it was not a self-affliction. My husband's father had COPD and sadly he struggled for the last few years of his life and had to use a nebulizer and had to have oxygen administered frequently but he persisted smoking until a few months prior to his death last May when he found he couldn't smoke. Now my husband's mother is suffering badly with her lungs and in the last year she has been hospitalised 3 times and has had oxygen and a nebulizer but she still persists on smoking.

I know myself with PBC if I was informed tomorrow that something I was ingesting was definitely not doing my liver any good then I'd do my utmost to eliminate it altogether.


Happened to come across this just now. One of many things worth knowing by smokers, particularly if they have a liver condition.

OSU - Oregon State University

"The recommended intake of vitamin C for smokers is 35 mg/day higher than for nonsmokers (for which they recommend 65 mg /day in the US) because smokers are under increased oxidative stress from the toxins in the cigarette smoke and generally have lower blood levels of Vitamin C."

Oxidative stress, toxins in the blood, liver detoxification processes (phase I and phase II, and their connections), antioxidants (among which vitamin C is an essential one, not only for immunity but also for circulation, brain activity, regeneration of vitamin E, another antioxidant, for tendons, ligaments and bones etc) - these are terms one would benefit from learning about and understanding their implications in PBC and generally, in one's health.


Firstly, I would say that smoking, per se, is not the cause of PBC.

I have yet to look properly at the research paper and/or its workings. I have, however, read in various places that smoking, nail varnish, hair dye and even nail varnish remover are the triggers for PBC. I have noted that the paper itself involves 199 people with PBC as one of the cohorts. We do not know how they were selected. This is not, in research terms, an enormous cohort. We know PBC affects smokers and non-smokers. we know PBC affects men and women. We know PBC affects those who dye their hair and those who do not. We know PBC affects those who paint their nails (and that might just be the men) and those who have never touched nail varnish.

What triggers PBC is a complex issue. The immune system is designed to stave off millions of agents: viral, chemical, bacterial, etc. Any one of these types of agents could be the one that triggers the known genetic predisposition.

Most people on this planet, affected by PBC or not, are aware that smoking is not exactly the best thing to do for your body, particularly in the long term. We, as an organisation, encourage our members to stop smoking. If someone does actually have to go to liver transplantation, the indicators are that non-smoking is advantageous for the potential recipient.

With regard to people dying with PBC. We are aware that this happens in a very small number of patients. With Urso, with better self management, with better education and with earlier diagnosis this, thankfully, is very much on the decrease.

It is estimated that there are 20,000 people in the UK with PBC. On average, 70-80 people with PBC are transplanted with a new liver each year in the UK. I don't have the figures to hand re people taken off the list or not put on to it, but you can get a picture in terms of how many people with PBC actually progress far enough to need a liver transplant: very few indeed.

Whilst we still feel this is too many, and we are fighting every day for better health care, management, diagnosis and timeliness of treatment. The case of Cristina's mother is one that happened in Romania. Romania is a very dfferent country to UK, USA, Canada in terms of its treatment of PBC, in terms of how it is managed, in terms of transplantations.

From memory, there were more PBC transplants for liver in the UK last year than there were liver transplants for all dieseases in Romania. (I can check this, if needs be.) The current life expectancy of PBC in Romania is between 7 and 10 years. These figures always rankle me (on a personal basis) as they often do not take into account age of diagnosee, age at diagnosis or sometimes even cause of death.

I cannot kee count of the number of paople I have met who have been diagnosed 15, 20, 25, even 30 + years with PBC. As time passes, these figues will increase steadily.

We currently have a questionnaire on the PBC Foundation website which directly asks this question as part of the questionnaire. (If you have not already done so, please take part in the survey. These are invaluable tools in terms of up to date accurate information which can help dispel the utter nonsensical myths that people with PBC have a life exectancy of 7 years. So, please help us to get real fidures out there!!)

If you would like to discuss anything in this thread, or even on health Unlocked in general, please call myself or Collette at the PBC Foundation.

44 131 556 6881

Yours, as ever,


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Thank you Robert. As I mentioned twice I think, any individual case cannot make for a statistics, what I said about my situation is but a single case.

The fact that many doctors recommend quitting smoking in case of liver conditions is, on the other hand, as the Compendium also states, another thing.

The current life expectancy of PBC in Romania is Not between 7 and 10 years, these are just the figures that go around many doctors because their papers still say so. But it remains a fact that most specialists, as Robert says, say that PBC is a condition which does not come against a quite normal life expectancy.


Thanks, Cristina. With apologies, I got ahead of myself. I was trying to say that many doctors still believe life expectancy in Romania with PBC is 7 to 10 years, for all we know that is not the case. I have edited the paragraph to take into account your correction. :~)


Hi, I was told I had PBC yesterday. I am 65 years old and live in the state of Florida in the United States of America. I am taking Ursodiol 300 mg. twice a day. I am reading any material I can find to learn more PBC. I am so thankful for this site.



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