Tuberculosis and tobacco smoking: a risk of development and specific features in smoking patients

The purpose of the study was to investigate effects of smoking on risk of pulmonary tuberculosis and clinical course of newly diagnosed tuberculosis. Methods. We questioned 342 patients with newly diagnosed pulmonary tuberculosis (of them, 296 active smokers; 86.5%) and 386 healthy individuals (115 smokers; 29.8%). To analyze an effect of smoking on occurrence of pulmonary tuberculosis, the odds ratio (OR), absolute and attributive risks and potential hazard index (number of subjects who should be exposed to a hazardous factor for development one case of a disease) were calculated. Results. Tobacco smoking was associated with 15-fold increase in the risk of tuberculosis (OR 15.16; 95%CI: 10.37; 22.16). This risk was directly related to number of cigarettes smoked per day and to smoking duration. The potential hazard index was less related to number of cigarettes smoked per day (3.87) or smoking duration (4.87) and more closely related to the smoking itself (1.74). Clinical course of pulmonary tuberculosis was analyzed in 296 active smokers with newly diagnosed disease. Conclusion. More severe course of newly diagnosed pulmonary tuberculosis was related to starting tobacco smoking at earlier age, smoking duration, and greater number of cigarettes smoked per day. Furthermore, heavier smoking was associated with more extending lung injury. Tobacco smoking was related to probability of development of pulmonary tuberculosis and to severity of the disease. There is a need of smoking control both in healthy population and in patients with tuberculosis.

1. Yablonskiy P.K., Sukhovskaya O.A. Tuberculosis and tobacco smoking. Actual issues and future directions of control of tuberculosis in Russian Federation. In: The 1st Congress of National Association of Phthisiatricians. Saint-Petersburg; 2012: 322–323 (in Russian).

2. Yablonskiy P.K., Sukhovskaya O.A. pulmonary tuberculosis and tobacco smoking (a review). Tuberkulez i bolezni legkikh. 2012; 12: 51–56 (in Russian).

3. Shul'min A.V., Kozlov V.V., Kutumova O.Yu. et al. Healthcare costs due to smoking-related diseases in Krasnoyarsk krai. Sibirskoe meditsinskoe obozrenie. 2013; 4: 74–77 (in Russian).

4. Antonov N.S., Sakharova G.M. Tobacco smoking and tuberculosis: effects and treatment. Russkiy meditsinskiy zhurnal. 2014; 22 (5): 366–371 (in Russian).

5. Kruijshaar M.E., Lipman M., Essink-Bot M.L. et al. Health status of UK patients with active tuberculosis. Int. J. Tuberc. Lung Dis. 2010; 14 (3): 296–302.

6. Shprykov A.S. Clinical features and efficacy of treatment of pulmonary tuberculosis and bacterial diseases under chronic tobacco dependence (experimental and clinical trials): Diss. Moscow; 2011 (in Russian).

7. Shprykov A.S. Clinical features of pulmonary tuberculosis in smoking patients. Tuberkulez i bolezni legkikh. 2011; 9: 11–14 (in Russian).

8. Chiang Y.C., Lin Y.M., Lee J.A. et al. Tobacco consumption is a reversible risk factor associated with reduced successful treatment outcomes of anti-tuberculosis therapy. Int. J. Infect. Dis. 2012; 16 (2): 130–135.

9. Shin S.S., Xiao D., Cao M. et al. Patient and doctor perspectives on incorporating smoking cessation into tuberculosis care in Beijing, China. Int. J. Tuberc. Lung Dis. 2012; 16 (1): 126–131.

10. Sun H.J., Golub J.E., Jo J. et al. Smoking and risk of tuberculosis incidence, mortality, and recurrence in South Korean. Am. J. Epidemiol. 2009; 170 (12): 1478–1485.

11. Shprykov A.S. Pharmacokinetics of rifampicin and tolerability of chemotherapy of pulmonary tuberculosis in tobacco smokers. Tuberkulez i bolezni legkikh. 2010; 9: 22–24 (in Russian).

12. Global Surveillance of Adult Population on Tobacco Comsumption. Russian Federation. Moscow: Rosstat; 2009: 172 (in Russian).

13. Revyakina O.V., Alekseeva T.V., Filippova O.V. et al. General Parameters of Tuberculosis Control Activity in Siberian and Far Eastern Federal Districts. Novosibirsk: NIIT; 2014: 87 (in Russian).