Publication

Abstract : Both tobacco smoking and tuberculosis are major global public health problems. Tobacco smoking has been linked as a risk factor for TB. This study was aimed to find the association between smoking and pulmonary TB. Materials and methods: Pulmonary TB patients aged between 17 and 85 years were enrolled over a period of 9 months. All patients had two consecutive sputum smears examined for the presence of acid –fast bacilli (AFB) using Fluorescence Microscopy technique at the initiation of treatment and repeated as per recommendations of the RNCTP. Response was determined in terms of sputum conversion at the end of intensive phase and final treatment outcomes. Results: Out of total of 124 current smokers, a very high number of patients 83(66.7%)were found to have a high load of TB bacilli(3+), these smokers with sputum 3+ grade showed less response to TB drug treatment. Out of 83 patients, only 15 patients (18.7%) showed smear conversion at the end of intensive treatment. 45 patients who had cavitary disease , 30 (66%)patients had cleared at the end of IP and 15 patients showed persistence of cavitation in smokers while 76% of non smokers showed clearance of cavity(P<0.05). Cure rate among smokers, ex smokers and non smokers were 52.5%, 78% and 84%, respectively. Conclusion: Smokers during initial presentation, as well as at end of the treatment indicate more radiological findings, cavitary disease, and worse sputum AFB smear grading. Smokers also had a poorer outcome in terms of treatment success rate as compared to non smokers. This was largely due to high percentage of default rate among smokers implying treatment adherence issues among smokers as a main confounder to treatment success. Focus needs to be made to reduce defaulters which are more common among smokers.