Abstract
Smoking has been implied as a risk factor for tuberculosis (TB) infection, lengthening of time to culture conversion and worse outcomes in TB.
It is believed that the immunological repercussions of smoking are reversed within 6 weeks of its cessation.
We aimed to study the association between active smoking and tuberculosis characteristics and outcomes in a portuguese population.
A cohort of adult patients diagnosed with pulmonary and/or pleural TB from a portuguese hospital, between 2007 and 2013, was retrospectively analysed.
In a population of 681 patients, smoking status was known in 551, with 43,9% being active smokers at the time of diagnosis.
Active smoking status was significantly associated (p<0.05) with sex, alcohol abuse, HIV infection and chronic respiratory disease. Active smokers also had more frequently weight loss and hypersudoresis at presentation, as well as high bacillary load in sputum smear at diagnosis, cavitation on chest X-ray, bilateral infiltrates and any kind of drug resistance. No significant association was found between active smoking and time to culture conversion >2 months or death.
These results show an association of smoking with other TB risk factors (alcohol abuse, HIV infection, chronic respiratory disease) and a significant impact of tobacco exposure in almost every aspect of TB evolution, such as clinical presentation, radiological extent of disease and its potential contagiousness (smear bacillary load).
Our results reinforce the importance of smoking cessation to become a tool in the improvement of TB treatment.
- Copyright ©the authors 2016