OBJECTIVES: To assess the strength of evidence in published articles for an association between smoking and passive exposure to tobacco smoke and various manifestations and outcomes of tuberculosis (TB). Clinicians and public health workers working to fight TB may not see a role for themselves in tobacco control because the association between tobacco and TB has not been widely accepted. A qualitative review and meta-analysis was therefore undertaken. METHODS: Reference lists, PubMed, the database of the International Union Against Tuberculosis and Lung Disease and Google Scholar were searched for a final inclusion of 42 articles in English containing 53 outcomes for data extraction. A quality score was attributed to each study to classify the strength of evidence according to each TB outcome. A meta-analysis was then performed on results from included studies. RESULTS: Despite the limitations in the data available, the evidence was rated as strong for an association between smoking and TB disease, moderate for the association between second-hand smoke exposure and TB disease and between smoking and retreatment TB disease, and limited for the association between smoking and tuberculous infection and between smoking and TB mortality. There was insufficient evidence to support an association of smoking and delay, default, slower smear conversion, greater severity of disease or drug-resistant TB or of second-hand tobacco smoke exposure and infection. CONCLUSIONS: The association between smoking and TB disease appears to be causal. Smoking can have an important impact on many aspects of TB. Clinicians can confidently advise patients that quitting smoking and avoiding exposure to others' tobacco smoke are important measures in TB control.
OBJECTIVES: To assess the strength of evidence in published articles for an association between smoking and passive exposure to tobacco smoke and various manifestations and outcomes of tuberculosis (TB). Clinicians and public health workers working to fight TB may not see a role for themselves in tobacco control because the association between tobacco and TB has not been widely accepted. A qualitative review and meta-analysis was therefore undertaken. METHODS: Reference lists, PubMed, the database of the International Union Against Tuberculosis and Lung Disease and Google Scholar were searched for a final inclusion of 42 articles in English containing 53 outcomes for data extraction. A quality score was attributed to each study to classify the strength of evidence according to each TB outcome. A meta-analysis was then performed on results from included studies. RESULTS: Despite the limitations in the data available, the evidence was rated as strong for an association between smoking and TB disease, moderate for the association between second-hand smoke exposure and TB disease and between smoking and retreatment TB disease, and limited for the association between smoking and tuberculous infection and between smoking and TB mortality. There was insufficient evidence to support an association of smoking and delay, default, slower smear conversion, greater severity of disease or drug-resistant TB or of second-hand tobacco smoke exposure and infection. CONCLUSIONS: The association between smoking and TB disease appears to be causal. Smoking can have an important impact on many aspects of TB. Clinicians can confidently advise patients that quitting smoking and avoiding exposure to others' tobacco smoke are important measures in TB control.
Authors: Yuri F van der Heijden; Fareed Abdullah; Bruno B Andrade; Jason R Andrews; Devasahayam J Christopher; Julio Croda; Heather Ewing; David W Haas; Mark Hatherill; C Robert Horsburgh; Vidya Mave; Helder I Nakaya; Valeria Rolla; Sudha Srinivasan; Retna Indah Sugiyono; Cesar Ugarte-Gil; Carol Hamilton Journal: Tuberculosis (Edinb) Date: 2018-10-01 Impact factor: 3.131
Authors: Y Lin; L-X Wang; L-X Qiu; Q Huang; Q Shu; H-X Lin; X Meng; X-L Zeng; L-X Xiao; T S Bam; C-Y Chiang Journal: Public Health Action Date: 2015-09-21
Authors: Juan-Pablo Millet; Antonio Moreno; Laia Fina; Lucía del Baño; Angels Orcau; Patricia García de Olalla; Joan A Caylà Journal: Eur Spine J Date: 2012-05-08 Impact factor: 3.134
Authors: S S Shin; R Laniado-Laborin; P G Moreno; T E Novotny; S A Strathdee; R S Garfein Journal: Int J Tuberc Lung Dis Date: 2013-11 Impact factor: 2.373
Authors: Richard N van Zyl-Smit; Anke Binder; Richard Meldau; Patricia L Semple; Alicia Evans; Peter Smith; Eric D Bateman; Keertan Dheda Journal: Thorax Date: 2013-11-28 Impact factor: 9.139