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In contrast, the slightly greater thyroid size in smokers is observed in iodine\u2010deficient but not in iodine\u2010sufficient areas and caused by competitive inhibition of thyroidal iodide uptake by thiocyanate. Smokers have an increased prevalence of nontoxic goitre and thyroid multinodularity, at least in iodine\u2010deficient areas. Current smoking reduces dose dependently the risk of thyroid cancer, which is more pronounced for papillary than for follicular types; the risk in former smokers approaches that of never smokers. The lower <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> and lower body mass index in smokers might contribute to this reduced risk. Current smoking lowers the risk of developing thyroid peroxidase and thyroglobulin antibodies and subclinical and overt autoimmune hypothyroidism; the effect is dose dependent, but disappears within 3\u00a0years after quitting smoking. There is evidence from an animal model of experimental autoimmune thyroiditis that anti\u2010inflammatory effects of nicotine are involved. In contrast, smoking is a dose\u2010dependent risk factor for Graves\u2019 hyperthyroidism and especially for Graves\u2019 ophthalmopathy. Smoking is related to a higher recurrence rate of Graves\u2019 hyperthyroidism, a higher risk on Graves\u2019 ophthalmopathy after 131I therapy and a less favourable outcome of <jats:styled-content style=\"fixed-case\">GO<\/jats:styled-content> treatment with steroids or retrobulbar irradiation. The observed associations with smoking likely indicate causal relationships in view of consistent associations across studies, the presence of dose\u2013response effects and disappearance of associations after cessation of smoking.<\/jats:p>","DOI":"10.1111\/cen.12222","type":"journal-article","created":{"date-parts":[[2013,4,13]],"date-time":"2013-04-13T13:06:46Z","timestamp":1365858406000},"page":"145-151","source":"Crossref","is-referenced-by-count":348,"title":["Smoking and thyroid"],"prefix":"10.1111","volume":"79","author":[{"given":"Wilmar M.","family":"Wiersinga","sequence":"first","affiliation":[{"name":"Department of Endocrinology &amp; Metabolism Academic Medical Center University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1460153"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2004.02161.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.01867"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0431"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-924264"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.13.1428"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0023"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0110"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.etap.2012.09.010"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0762"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03350348"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-2225"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-1180"},{"key":"e_1_2_9_15_1","first-page":"114","article-title":"Tobacco smoking and thyroid function: is weight gain a confounder?","volume":"168","author":"Liel Y.","year":"2008","journal-title":"Archives of Internal Medicine"},{"key":"e_1_2_9_16_1","first-page":"400","article-title":"Association between serum TSH concentration and body mass index in euthyroid subjects: the role of smoking","volume":"15","author":"Mehran L.","year":"2012","journal-title":"Archives of Iranian Medicine"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2008.03239.x"},{"key":"e_1_2_9_18_1","first-page":"114","article-title":"Tobacco smoking and thyroid function: is weight gain a confounder? 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