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Smoking and tuberculosis among silicotic patients

¹ Tuberculosis and Chest Service, Centre for Health Protection, Department of Health, and ² Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong, China.

CORRESPONDENCE: C. C. Leung, Pneumoconiosis Clinic, 4/F 8 Chai Wan Road, Shaukeiwan, Hong Kong, China. Fax: 852 29775940. E-mail: cc_leung{at}dh.gov.hk

Keywords: Cohort study, smoking, tuberculosis

Received: October 16, 2006
Accepted December 4, 2006

The aim of the present study was to investigate the relationship between smoking and tuberculosis (TB) among high-risk silicotic patients in Hong Kong.

A cohort of 435 silicotic patients tuberculin tested from 1995–2002 was prospectively followed-up until the end of 2005. Baseline characteristics were analysed with respect to positive tuberculin reaction (10 mm) at baseline and subsequent development of TB.

Smoking, alcohol use and body mass index were independent predictors of positive tuberculin reaction at baseline in multiple logistic regression analysis. Total cigarette pack-yrs did not demonstrate any significant effect. The annual incidences of TB were 1,841, 2,294 and 4,181 per 100,000 for never-, ex- and current smokers, respectively. On Cox proportional hazard analysis, current smokers have a significantly higher risk of TB than other silicotic patients (adjusted hazard ratio (95% confidence interval (CI)): 1.96 (1.14–3.35)) after controlling for age, alcohol use, tuberculin status, treatment for latent TB infection and other relevant background/disease factors. A significant dose-response relationship was also observed with the daily number of cigarettes currently smoked. Smoking cessation may reduce 32.4% (95% CI: 6.5–54.0) of the risk.

Smoking increases the risk of both tuberculosis infection and subsequent development of the disease among silicotic patients.

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