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While chronic infections with HBV and HCV, heavy alcohol consumption, and diabetes are well-established primary risk factors for HCC, there is compelling and growing evidence that prolonged and active cigarette smoking is an independent and significant risk factor for its development [98, 99]

In addition to being highly addictive, nicotine can result in increased blood pressure, heart rate, blood flow to the heart, constriction of arteries, and heart attacks due to the hardening of arterial walls

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In several cell culture and animal models, arsenic has been found to act as an endocrine disruptor, which may underlie many of its health effects