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Abstract
Objective
Smoking has been associated with tuberculosis (TB); however, the effects of smoking on the effectiveness of TB treatment remain unclear.
Materials and methods
Data were retrieved from case notes and interviews of subjects registered in the TB-reporting system from 2010 to 2012. Study cases were defined as subjects with TB-positive sputum cultures, whereas the controls were defined as subjects with non-TB-related pulmonary diseases. Statistical analyses included logistic regression and multivariate Cox proportional hazard regression models.
Results
A total of 245 cases with cultures positive for TB and 114 controls with non-TB-related pulmonary diseases and negative sputum cultures were recruited. Current smokers had the highest failure rate (33%) for TB treatment, and they had the most severe pulmonary lesions based on chest X-ray grading. Current smokers had a 1.36-fold (95% confidence interval 1.03–2.36, P<0.05) higher odds ratio for cultures positive for TB compared with nonsmokers. In subjects with TB-positive cultures, current smoking was associated with an increase in treatment days required for cultures to convert from positive to negative (hazard ratio 1.12, 95% confidence interval 1.03–1.39; P<0.05).
Conclusion
Longer periods of treatment may be required for TB patients who are current smokers.
Acknowledgments
The authors wish to thank Mrs Chiao-Ju Fu and Ching-Ling Li for technical assistance in this research. This study was founded by the Ministry of Science and Technology of Taiwan (MOST103-2314-B-038-018 and 104-2621-M-038-002-MY3) and the Shuang Ho Hospital (104-SHH-HCP-015).
Disclosure
The authors report no conflicts of interest in this work.