does chewing tobacco affect fatty liver Toxic effects of smokeless on female reproductive health: A review Tobacco, Cigarettes, and the Liver:

Some observational studies suggest that patients with NAFLD who continue using tobacco products may have higher rates of advanced fibrosis compared to non-users with similar metabolic profiles, though the strength of evidence specific to smokeless tobacco remains uncertain

Communities can advocate for stricter enforcement of bans to reduce availability and prevent new users.Chewing tobacco is far more dangerous than many assume

Research suggests that nicotine and other tobacco constituents may contribute to hepatic steatosis through several metabolic pathways

Thats why the FDAs pre-marketing authorization only allows nicotine pouches to be marketed as a modified risk tobacco product. The manufacturers know that the tobacco-derived nicotine in their products is not pure enough to qualify for medicinal status

But we wont know the exact level of harm for certain until we have years of accumulated data to analyze