In a new study, researchers from the Harvard School of Public Health (HSPH) undertook a systematic review and meta-analysis of epidemiologic data to quantitatively assess the association between smoking, passive smoking and indoor air pollution and tuberculosis (TB). They found consistent evidence that smoking is associated with an increased risk of TB; they also found that passive smoking (secondhand smoke) and the burning of biomass fuels was associated with an increased TB risk.
"The evidence suggests that, when compared to non-smokers, smokers have about double the risk of tuberculosis. The implication for global health is critical," said Megan Murray, associate professor of epidemiology at HSPH. "Since tobacco smoking has increased in developing countries where TB is prevalent, a considerable portion of the global burden of TB may be attributed to tobacco. Importantly, this also implies that smoking cessation might provide benefits for global TB control in addition to those for chronic diseases."
The researchers found that, compared with non-smokers, smokers have an increased risk of having tuberculosis infection, of having active TB disease, and of dying from the disease. They also found evidence of an association between passive smoking and indoor air pollution and an increased risk of TB, though the evidence was more limited due to a substantially smaller number of studies. The researchers advocate larger rigorously designed studies in the future to substantiate that association.
"Our findings suggest that information on people's exposure to respirable pollutants from sources such as smoking and biomass use will help TB detection efforts. Additionally, TB control programs may benefit from including interventions aimed at reducing tobacco exposure, especially among those at high risk for exposure to infection," said Majid Ezzati, associate professor of international health.
MEDICA.de; Source: Harvard School of Public Health