Association Between Tuberculosis and Smoking

Background: The association between smoking and tuberculosis (TB), which has been proven in multiple studies with different study population ethnicity, has not yet re- ceived sufficient attention in terms of TB control. Objectives: The aim of the present study was to determine the association between TB and cigarette smoking in southeastern Iran, an endemic area for tuberculosis. Patients and Methods: This prospective case-control study conducted at a University- Affiliated Hospital (Boo-Ali Hospital, Zahedan, and Southeastern Iran) from March 2007 to March 2012 enrolled 253 TB patients and 312 healthy controls. Factors including his- tory of cigarette smoking, duration of smoking, number of cigarettes smoked per day, consumption of other drugs (parenteral and non-parenteral), and family history of tu- berculosis and smoking, were evaluated in both cases and controls. Univarate and multi- variate logistic regressions were performed to compare TB cases and controls. The odds ratio (OR) and 95% confidence intervals (CI) were also estimated. Results: The results of the study revealed a significant difference between TB and control groups in relation to smoking (P 0.0001). In multivariate logistic regression, cigarette smokers were 3.1 (95% CI: 1.4-10.3) times more frequent in TB patients compared with con- trols. Other factors that showed significant differences between TB patients and controls were the use of non-parenteral drugs (OR = 3.6, 95% CI: 2.2-21.4), family history of TB (OR = 6.6, 95% CI: 2.3-18.2), family history of smoking (OR = 2.8, 95% CI: 1.1-8.4), and smoking history of more than 10 years (OR = 1.6, 95% CI: 1.2-9.8). Conclusions: The present study evidenced the association between TB and smoking. It is therefore recommended to include interventions for smoking cessation in the current TB control practice.