Association of Smoking and Drug Abuse with Treatment Failure in Individuals with Tuberculosis: A Case-Control Study

Abstract

Introduction: Treatment failure in tuberculosis (defined as a positive sputum smear 5 months after the initiation of anti-TB treat-ment) is a major threat to the control over TB. This study aimed to investigate the association of smoking and drug abuse with treatment failure among individuals with TB. Material and methods: Out of 286 TB patients with available data registered by the health system of Hamadan Provinces in western Iran, 24 TB patients with treatment failure (positive sputum smear, 5 months after initiation of anti-TB treatment) and 262 patients without treatment failure (negative sputum smear, five months after initiation of anti-TB treatment) were selected as case and control groups, respectively. These two groups were compared to each other in terms of demographic status which include age, sex, job, residence, and risk factors such as smoking and drug abuse status. An odds ratio (OR) with a 95% confidence interval was used as a measure of association. The Bonferroni correction was used to counteract multiple comparisons, therefore, a p-value of less than 0.004 was statistically significant. Results: No significant association was found between treatment failure and age, residence, comorbidity, education level, job status, sex, smoking, and method of drug abuse (P > 0.004). However, a significant association was found between duration of smoking, number of cigarettes per day, and drug abuse with treatment failure in univariate analysis (P < 0.004). In multivariate analysis, only an association with drug abuse was significantly associated with treatment failure (P = 0.047). Conclusion: Drug abuse substantially increases the risk of treatment failure. Therefore, in order to control TB, it is suggested that preventive programs are designed in order to decrease drug abuse among TB patients before starting treatment.

Is Tobacco Use Associated With Risk of Recurrence and Mortality Among People With TB?

“…Regarding treatment failure, nine of 12 identified studies provided risk estimates, all reporting increased risk with tobacco use. 26 , 42 , 52 , 57 , 62 , 74 , 82 , 93 , 119 , 123 , 126 , 138 So-called unsuccessful treatment, which combined any outcome other than cure or completion of treatment, was reported in 28 studies. 24 , 49 , 60 , 61 , 65 , 68 , 71 , 73 , 78 , 80 , 85 , 87 , 90 , 91 , 94 , 95 , 104 , 107 , 108 , 114 , 117 , 122 , 123 , 126 , 137 , 140 , 145 , 146 Of these, the risk could not be extracted from four studies, 24 , 49 , 61 , 137 whereas most of the remaining ones reported increased risk, including three studies that included the use of ST products.…”

The impact of comorbidities on tuberculosis treatment outcomes in Poland: a national cohort study

“…Secondly, the increased risk of reinfection among this vulnerable population further complicates their treatment outcomes ( 33 ). Persistent exposure to TB in environments where substance abuse is prevalent can lead to recurring infections, making it challenging to achieve successful treatment outcomes ( 34 ). Moreover, the issue of poor treatment adherence among individuals grappling with addiction plays a critical role in the treatment’s effectiveness.…”

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