The effect of drinking coffee and smoking cigarettes on the risk of cirrhosis associated with alcohol consumption

Abstract

In order to assess the interaction between alcohol intake, tobacco smoking and coffee consumption in determining the risk of liver cirrhosis we carried out a hospital-based case-control study involving 115 patients at their first diagnosis of cirrhosis and 167 control patients consecutively enrolled in the General Hospitals of the Province of L'Aquila (Central Italy). The mean life-time daily alcohol intake (as g ethanol consumed daily) was measured by direct patient interviews, whose reproducibility was > 0.80 and similar for cases and controls, as checked by interviewing the relatives of a sample of 50 cases and 73 controls. During the same patient's interview we also measured the mean consumption of coffee (daily number of cups of filtered coffee) and tobacco (life-time daily number of cigarettes smoked). A dose-effect relationship on the risk of cirrhosis was present both for alcohol intake--for which the risk was significantly increased above 100 g of daily intake--and for cigarette consumption. The latter did not however improve the goodness-of-fit of a logistic regression model including alcohol intake as covariate. By contrast, coffee consumption had a protective effect on the risk of cirrhosis and significantly improved the goodness-of-fit of such a model. Abstaining from coffee consumption determined both a significantly increased risk of cirrhosis, even for daily alcohol intake below 100 g, and a multiplicative effect with alcohol intake on this risk. In patients drinking > or = 101 g ethanol daily the relative risk increased from 5.5 (95% confidence interval: 1.4-22.0) for coffee consumers to 10.8 (95% confidence interval: 1.3-58.1) for coffee abstainers.(ABSTRACT TRUNCATED AT 250 WORDS)

Southern Europe as an example of interaction between various environmental factors: a systematic review of the epidemiologic evidence

“…Other case-control studies carried out in South Europe have demonstrated a dose-effect relationship of increased risk for both cirrhosis and HCC with increasing alcohol intake, when also adjusting for HBV and HCV infection (Corrao et al, 1993(Corrao et al, , 1997Bellentani et al, 1994;Corrao and Arico`, 1998;Kuper et al, 2000a). On the same line, two meta-analyses conducted by Corrao et al (1998aCorrao et al ( , 2004 on the risk of cirrhosis and of various neoplasms, including liver cancer, show a continuous curve of increasing risk of disease with increasing alcohol intake.…”

Does coffee protect against hepatocellular carcinoma?

“…In several case-control studies, coffee consumption showed an inverse association with the incidence or diagnosis of liver cirrhosis, with significant trends in risk with dose and duration (Klatsky and Armstrong, 1992;Klatsky et al, 1993;Corrao et al, 1994Corrao et al, , 2001Gallus et al, 2002). Since liver cirrhosis is strongly related to the incidence of hepatocellular carcinoma (Adami et al, 1992;La Vecchia et al, 1998, Kuper et al, 2000, the apparent protective effect of coffee consumption on hepatocellular carcinogenesis may be due to its inverse relation with liver cirrhosis.…”

“…The possible relation between coffee drinking and the risk of several cancers, particularly of cancers of the urinary bladder, pancreas and colorectum, has been widely investigated. These have shown a direct relation with bladder, an inverse one with colorectum, but no consistent association with other major sites, including liver cancer (IARC, 1991;Tavani and La Vecchia, 2000).Coffee drinking has been inversely related to the risk of liver cirrhosis in several studies (Klatsky and Armstrong, 1992;Klatsky et al, 1993;Corrao et al, 1994Corrao et al, , 2001Gallus et al, 2002). Although cirrhosis is a major correlate of hepatocellular carcinoma (Adami et al, 1992;La Vecchia et al, 1998, Kuper et al, 2000, the relation between coffee drinking and risk of hepatocellular carcinoma has been examined in only two studies which provided, however, no definite results.…”

Cigarette Smoking and Hepatic Lesions in Patients With Chronic Hepatitis C

“…Tobacco consumption was not studied in these papers. However cigarette smoking was found to be independently related to the risk of alcoholic cirrhosis in 2 studies, 1,2 and to the risk of cirrhosis in a cohort of 1,506 chronic hepatitis B virus carriers in another one. 3 In a recent study we found that smoking increased 5-year mortality rates of patients with alcoholic cirrhosis.…”