A case-control study was carried out to assess if the tobacco smoking is associated with development of active pulmonary tuberculosis in 153 cases with active pulmonary tuberculosis and 160 control subjects. Detailed information on smoking habits was collected from cases and controls using questionnaire. It was seen that tobacco smoking was associated with pulmonary tuberculosis. The estimated crude odd's ratio (OR) of the association was 1.66 (95% confidence interval: 1.01-2.73) . The age adjusted OR was 1.70 (95% CI: 1.01-2.88), p < 0.05. The increased risk for pulmonary tuberculosis was significant in men who had smoked for over 20 years (OR 3.07; 95% CI: 1.37-6.86). The adjusted OR for heavy smokers (more than 20 bidis per day) was 2.72 (95% CI: 1.19-6.20). There was a dose-response relationship between the number of bidis smoked daily and the risk of development of pulmonary tuberculosis. The study showed that tobacco smoking is associated with pulmonary tuberculosis, with a dose-response relationship with the number of bidis consumed daily.