Tobacco smoking and tuberculosis treatment outcomes: a prospective cohort study in Georgia

• DOI: 10.2471/blt.14.147439
• Publication Date: 2015-06-01T10:37:24Z
• Authors: Medea Gegia; Matthew J Magee; Russell R Kempker; Iagor Kalandadze; Tsira Chakhaia; Jonathan E Golub; Henry M Blumberg
• Keywords: Adult; Male; Adolescent; 610; Georgia (Republic); Young Adult; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Surveys and Questionnaires; 616; Prevalence; Humans; Tuberculosis; Prospective Studies; Research; Smoking; Middle Aged; Treatment Outcome; Regression Analysis; Female; Public Health; Public aspects of medicine; RA1-1270

To assess the effect of tobacco smoking on the outcome of tuberculosis treatment in Tbilisi, Georgia.We conducted a prospective cohort study of adults with laboratory-confirmed tuberculosis from May 2011 to November 2013. History of tobacco smoking was collected using a standardized questionnaire adapted from the global adult tobacco survey. We considered tuberculosis therapy to have a poor outcome if participants defaulted, failed treatment or died. We used multivariable regressions to estimate the risk of a poor treatment outcome.Of the 591 tuberculosis patients enrolled, 188 (31.8%) were past smokers and 271 (45.9%) were current smokers. Ninety (33.2%) of the current smokers and 24 (18.2%) of the participants who had never smoked had previously been treated for tuberculosis (P < 0.01). Treatment outcome data were available for 524 of the participants, of whom 128 (24.4%) - including 80 (32.9%) of the 243 current smokers and 21 (17.2%) of the 122 individuals who had never smoked - had a poor treatment outcome. Compared with those who had never smoked, current smokers had an increased risk of poor treatment outcome (adjusted relative risk, aRR: 1.70; 95% confidence interval, CI: 1.00-2.90). Those who had ceased smoking more than two months before enrolment did not have such an increased risk (aRR: 1.01; 95% CI: 0.51-1.99).There is a high prevalence of smoking among patients with tuberculosis in Georgia and smoking increases the risk of a poor treatment outcome.