Association between smoking and tuberculosis infection: a population survey in a high tuberculosis incidence area
ABSTRACT Associations between smoking and tuberculosis disease including death from tuberculosis have been reported, but there are few reports on the influence of smoking on the risk of developing Mycobacterium tuberculosis infection. The aim of this study was to determine the association between smoking and M tuberculosis infection.
In a cross sectional population survey, data on smoking and tuberculin skin test (TST) results of 2401 adults aged > or =15 years were compared.
A total of 1832 (76%) subjects had a positive TST (> or = 10 mm induration). Of 1309 current smokers or ex-smokers, 1070 (82%) had a positive TST. This was significantly higher than for never smokers (unadjusted OR 1.99, 95% confidence interval (CI) 1.62 to 2.45). A positive relationship with pack-years was observed, with those smoking more than 15 pack-years having the highest risk (adjusted OR 1.90, 95% CI 1.28 to 2.81).
Smoking may increase the risk of M tuberculosis infection.
SourceAvailable from: Zaheer Ahmad Nasir[Show abstract] [Hide abstract]
ABSTRACT: Ensuring an efficient and equitable delivery of quality assured diagnosis and treatment of tuberculosis (TB) is the major drive of the TB control programme and the alternatives for incorporating preventative efforts have not yet been fully considered. The aim of the study was to examine the social determinants of TB transmission in sub-Saharan Africa. Four electronic databases (Medline, CINAHL, PubMed, and Web of Science) were systematically searched to obtained relevant articles and critical appraisal skill programme tools were used to analyze data. Out 515 articles obtained from the electronic database search only 18 met the inclusion and exclusion criteria of the systematic review. The study shows that male sex, young age (25-34 years), low education, unemployment, low income, poverty, tobacco smoking, and alcohol abuse are the identified social determinants of tuberculosis in sub-Saharan Africa. Therefore, focus on social determinates of TB, adjunct to early diagnosis and successful treatment completion, can play a pivotal role in reducing the soaring levels to TB transmission in sub-Saharan Africa.
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ABSTRACT: This paper provides information on the association of tobacco smoking and alcohol consumption with pulmonary TB (PTB) in central India. A community based cross-sectional TB prevalence survey was conducted in Jabalpur district of the central Indian state of Madhya Pradesh. The information on tobacco smoking and alcohol consumption was collected from individuals aged a parts per thousand yen15 years. Using logistic regression analysis, the risk factors for PTB were identified. A total of 94 559 individuals provided information on tobacco smoking and alcohol consumption. Persons aged 35-54 years and 55 years and above had, respectively, a 2.19 (95% CI 1.57-3.07) and a 3.26 (95% CI 2.23-4.77) times higher risk of developing PTB compared to persons aged below 35 years. Males had a 2.35 (95% CI 1.66-3.32) times higher risk than females. Tribals (indigenous population) had a 2.32 (95% CI 1.68-3.21) times higher risk than non-tribal population. The adjusted prevalence odds ratio for mild, moderate and heavy tobacco smokers were 2.28, 2.51 and 2.74 respectively as compared to non-smokers. Alcohol consumption was not found to be a risk factor on multivariate analysis. Tobacco smoking is significantly associated with PTB in this central Indian district. Smoking cessation services need to be integrated into the activities of the TB control programme.Transactions of the Royal Society of Tropical Medicine and Hygiene 06/2014; 108(8). DOI:10.1093/trstmh/tru082 · 1.93 Impact Factor
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ABSTRACT: The impact of smoking on tuberculosis outcome was evaluated in a territory-wide treatment programme. 16 345 consecutive patients undergoing chemotherapy for active tuberculosis in government chest clinics in Hong Kong from 2001 to 2003 were followed up prospectively for 2 years for treatment outcome and subsequently tracked through the territory-wide tuberculosis notification registry for relapse until the end of 2012. Smoking was associated with more extensive lung disease, lung cavitation and positive sputum smear and culture at the baseline. In both current smokers and ex-smokers, sputum smears and cultures were significantly more likely to remain positive after 2 months of treatment. Both categories of smokers were significantly less likely to achieve cure or treatment completion within 2 years. Overall, 16.7% of unsuccessful treatment outcomes were attributable to smoking, with the key contributor being default in current smokers and death in ex-smokers. Among successful treatment completers, there was a clear gradient (hazard ratios of 1.00, 1.33, and 1.63) of relapse risk from never-smokers to ex-smokers and current smokers, with an overall population attributable risk of 19.4% (current smokers: 12.2%; ex-smokers: 7.2%). Smoking adversely affects baseline disease severity, bacteriological response, treatment outcome and relapse in tuberculosis. Smoking cessation likely reduces relapse and secondary transmission.European Respiratory Journal 10/2014; 45(3). DOI:10.1183/09031936.00114214 · 7.13 Impact Factor