Effects of smoking on the severity and transmission of pulmonary tuberculosis: A hospital-based case control study

Abstract

IntroductionThere is a high incidence of both smoking and tuberculosis (TB) in China. This study examined the risk factors for severe pulmonary TB (PTB) and positive tubercle bacilli in sputum.MethodsWe conducted a retrospective case-control study in a tertiary hospital from January 2017 to December 2018 (n = 917). The clinical and biological characteristics of patients were collected, and univariable and multivariable logistic regression analyses were performed to assess the factors associated with smoking in terms of the severity and transmission of PTB.ResultsPositive tubercle bacilli in sputum and severe PTB were much higher in smoking patients. Together with nutrition status, heavy smoking exhibited a 284% greater risk in severe PTB. Positive tubercle bacilli in sputum was significantly associated with hypoproteinemia and smoking regardless of the status, duration, and degree.ConclusionBecause cigarette smoking was strongly and inversely associated with hypoproteinemia, we conclude that smoking plays a critical role in the severity and transmission of PTB. Smoking cessation interventions should be employed to prevent severe PTB and decrease the transmission of PTB.

Global and regional estimates of tuberculosis burden attributed to high fasting plasma glucose from 1990 to 2019: emphasis on earlier glycemic control

“…It showed that the incidence rate of male is significantly higher than that of female, with strong evidence that men are disadvantaged in seeking and accessing TB care in many cases [ 26 ]. In addition, men tended to have higher rates of tobacco, alcohol use, and other known risk factors for TB [ 27 – 30 ]. Because of men’s role and occupational risks, they are considered to be more likely to be exposed to Mycobacterium tuberculosis [ 25 ].…”

Cigarette Smoking as a Risk Factor for Tuberculosis in Adults: Epidemiology and Aspects of Disease Pathogenesis

“…There is also clear evidence that smoking increases the severity of TB [ 27 , 34 , 35 , 36 , 37 , 38 , 39 ], while the study by Adegbite mentioned above also documented a higher number of pulmonary TB signs and symptoms in smokers (AOR = 2.74; 95% CI 2.28 to 6.73) [ 34 ]. In one study, smokers developed more pulmonary disease (AOR = 1.5), more cavitary lung disease (AOR 1.9), and were more likely to need hospitalisation (AOR 1.8) that was more protracted [ 35 ].…”

“…One study of current smokers versus non-smokers indicated that former patients with TB had a 1.36-fold (95% CI 1.03–2.36) higher OR for culture-positive TB ( p < 0.05) [ 37 ]. A very recent study reported a higher load of tubercle bacilli in sputum [ 39 ]. This was confirmed in an additional study in which the sputum mycobacterial load was significantly higher in smokers (AOR = 3.18; 95% CI 1.33 to 8.11) [ 34 ].…”

“…Given the vast impact of cigarette smoking on TB disease, it is not surprising that for many years researchers have been stressing the essential need for smoking cessation strategies to control TB as part of TB control programmes [ 16 , 23 , 27 , 34 , 36 , 39 , 42 , 43 , 44 , 46 , 48 ]. Unfortunately, some studies have indicated that, at least in some areas, physicians’ knowledge, attitude, and practices of smoking cessation were limited [ 49 ].…”

Risk factors and biomarkers for post-tuberculosis lung damage in a Chinese cohort of male smokers and non-smokers: protocol for a prospective observational study

“…In this prospective cohort study, we aim to focus on the effects of cigarette smoking on PTLD. In China, the prevalence of cigarette smoking was reported to range from 50% to 60% in TB cases 14–16. While it is uncommon for women in China to smoke, the smoking prevalence was reported to be 2%–12% in female patients with TB, and from 53% to 75% in male patients with TB 14–16.…”