The impact of smoking on adherence to treatment for latent tuberculosis infection

Abstract

Background: Studies have shown an association between smoking and tuberculosis (TB) infection, disease and TB-related mortality. We hypothesized that smokers with latent tuberculosis infection (LTBI) are less likely to comply with their LTBI treatment regimen, thus increasing their risk of developing active disease. We thus documented the impact of smoking on adherence to LTBI treatment.

Evaluation of a school-based program for diagnosis and treatment of latent tuberculosis infection in immigrant children

“…However, using a larger definition for completion in children treated during 9 months (>80% of the total dose within 1 year), adherence rate poorly differed (65.1%). Other studies have tried to determine factors for failure of LTBI treatment completion, both in adults [29,[33][34][35][36][37][38][39][40][41][42][43] and in children [12,14,15,44,45]. Somatic complaints during isoniazid treatment have been reported in poorly adherent adolescents, especially in females [46], but we did not find such an association.…”

Addressing smoking cessation in tuberculosis control

“…1,2 Although there is a lack of data on the direct effects of smoking cessation on TB treatment outcomes, available data suggest that smokers, especially male smokers, are less adherent to TB treatment (OR: 1.8; 95% confidence interval, CI: 1.0-3.3]), and thus at higher risk for treatment default and persistent infectivity. 9 They also place their families at risk of infection as a result of passive smoking in the household.…”

“…Thus, cessation may yield substantial positive effects on TB treatment outcomes, relapse and future lung disease. 9 The DOTS strategy offers access to smokers and guarantees regular patient-provider interaction.…”

A Theoretical Assessment of the Effects of Smoking on the Transmission Dynamics of Tuberculosis

“…4. This tends to support the argument that smoking enhances the rate at which individuals who are infected with Mtb progress to active TB (Lavigne et al 2006;Dhamgaye 2008). Thus, as the percentage of smokers increase, so do the number of active TB cases.…”

“…Latently infected smokers develop active TB through endogenous reactivation and exogenous re-infection at rates ωk and δφλ T , respectively. It is worth noting here that ω > 1, since latently infected smokers tend to develop active TB at a faster rate than latently infected non-smokers (Lavigne et al 2006;Dhamgaye 2008). Also, δ ∈ (0, 1) since primary infection confers some degree of immunity.…”