Smoking and tuberculosis among silicotic patients in Hong Kong

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

^* To whom correspondence should be addressed. E-mail: cc_leung{at}dh.gov.hk.

	Abstract

To study the relationship between smoking and tuberculosis among high-risk silicotic patients in Hong Kong

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

Smoking, alcohol use and body mass index were independent predictors of positive tuberculin reaction at baseline in multiple logistic regression analysis (all P<0.05). Total cigarette pack-years did not demonstrate any significant effect. The annual incidences of tuberculosis were 1841, 2294 and 4181 per100000 for never, ex- and current smokers respectively (P=0.028). On Cox proportional hazard analysis, current smokers have significantly higher risk of tuberculosis than other silicotic patients (adjusted hazard ratio:1.96, 95%CI:1.14-3.35) after controlling for age, alcohol use, tuberculin status, treatment for latent tuberculosis 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 disease among silicotic patients.

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