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Abstract
OBJECTIVE: Smoking appears to be causally associated with active tuberculosis (TB). However, there is insufficient evidence linking passive or active tobacco smoking with certain important outcomes, such as treatment response in multidrug-resistant TB (MDR-TB).
MATERIAL AND METHODS: The present study was a retrospective analysis of a cohort of hospitalised patients with MDR-TB treated in our clinic between February 2000 and March 2005. All patients were followed with monthly sputum smears for acid-fast bacilli, Löwenstein-Jensen cultures and a chest X-ray during treatment. The radiologic involvement of disease was categorised as extensive or limited.
RESULTS: Of 103 MDR-TB patients, 81 (78.6%) were male and 22 (21.4%) were female. The mean age was 40.50±13.50 years (range 14-72) and all were HIV-negative. Extensive radiologic involvement was evident in 22 cases (21.4%). Among the cohort, 34 (33%) were current smokers, and 27 (26.2%) were former smokers. In the group with a successful outcome, the mean cigarette consumption was 14.7±19.9 pack-years, whereas in the group with a poor outcome it was 40.5±44.4 (p=0.0001).
CONCLUSION: Prospective clinical studies are required to evaluate whether aggressive smoking cessation intervention, in addition to chemotherapy, will improve survival of patients with MDR-TB.