Journal Article

Tobacco smoking and tuberculosis treatment outcomes: a prospective cohort study in Georgia

Magee, Matthew J, Kalandadze, Iagor, Blumberg, Henry M, Gegia, Medea, Chakhaia, Tsira, Golub, Jonathan E, Kempker, Russell R

2015

Overview

To assess the effect of tobacco smoking on the outcome of tuberculosis treatment in Tbilisi, Georgia. We conducted a prospective cohort study of adults with laboratory-confirmed tuberculosis from May 2011 to November 2013. History of tobacco smoking was collected using a standardized questionnaire adapted from the global adult tobacco survey. We considered tuberculosis therapy to have a poor outcome if participants defaulted, failed treatment or died. We used multivariable regressions to estimate the risk of a poor treatment outcome. Of the 591 tuberculosis patients enrolled, 188 (31.8%) were past smokers and 271 (45.9%) were current smokers. Ninety (33.2%) of the current smokers and 24 (18.2%) of the participants who had never smoked had previously been treated for tuberculosis (P < 0.01). Treatment outcome data were available for 524 of the participants, of whom 128 (24.4%) - including 80 (32.9%) of the 243 current smokers and 21 (17.2%) of the 122 individuals who had never smoked - had a poor treatment outcome. Compared with those who had never smoked, current smokers had an increased risk of poor treatment outcome (adjusted relative risk, aRR: 1.70; 95% confidence interval, CI: 1.00-2.90). Those who had ceased smoking more than two months before enrolment did not have such an increased risk (aRR: 1.01; 95% CI: 0.51-1.99). There is a high prevalence of smoking among patients with tuberculosis in Georgia and smoking increases the risk of a poor treatment outcome.

• Publisher: World Health Organization,The World Health Organization
• Subject: Adolescent / Adult / Adults / Analysis / Clinical outcomes / Cohort analysis / Deaths / Drug therapy / Female / Georgia / Georgia (Republic) - epidemiology / Health / Health Policy & Services / History / HIV / Human immunodeficiency virus / Humans / Laboratories / Lung diseases / Male / Medical treatment / Middle Aged / Mortality / Mycobacterium / Nitric oxide / Organizations / Patient outcomes / Patients / Prevalence / Prospective Studies / Public health / Questionnaires / Regression Analysis / Risk Factors / Smoked / Smokers / Smoking / Smoking - adverse effects / Smoking - epidemiology / Studies / Substance abuse treatment / Surveys / Surveys and Questionnaires / Tobacco / Treatment Outcome / Treatment outcomes / Tuberculosis / Tuberculosis - complications / Tuberculosis - diagnosis / Tuberculosis - therapy / World Health Organization / Young Adult