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Abstract
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 (> or =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.
Highlights
Smoking, alcohol use and body mass index were independent predictors of positive tuberculin reaction at baseline in multiple logistic regression analysis
Smoking increases the risk of both tuberculosis infection and subsequent development of the disease among silicotic patients
The following baseline information was collected at the time of tuberculin testing: date of tuberculin testing; name; age; identity card number; ethnicity; smoking history; alcohol use; bacilli Calmette–Guerin (BCG) scar; coexisting medical conditions; occupation; duration of dust exposure; and disease indices according to the International Labour Organisation classification
Summary
Alcohol use and body mass index were independent predictors of positive tuberculin reaction at baseline in multiple logistic regression analysis. 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 observed with the daily number of cigarettes currently smoked. Smoking increases the risk of both tuberculosis infection and subsequent development of the disease among silicotic patients. Associated with latent TB infection (LTBI) [1,2,3], offered to newly confirmed cases without preactive TB disease [4,5,6,7,8] and TB-related death [9– vious history of TB.
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