Pai Madhukar, Mohan Alladi, Dheda Keertan, Leung Chi Chiu, Yew Wing Wai, Christopher Devasahayam J, Sharma Surendra K
Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada.
Expert Rev Anti Infect Ther. 2007 Jun;5(3):385-91. doi: 10.1586/14787210.5.3.385.
Tobacco consumption ranks high among the leading health risks and tuberculosis (TB) is a major public health issue in countries where the smoking problem has reached epidemic proportions. Given that both smoking and TB are major health concerns and are widely prevalent in several countries, it is surprising that the association between smoking and TB is still a matter of debate and controversy. Although several studies have evaluated the effect of smoking on TB, the association has been largely overlooked by the TB and public health communities at large. Three recent reviews, including two meta-analyses, have summarized a large body of published literature on the association between smoking and various TB outcomes. These reviews show that there is considerable evidence that tobacco smoking is associated with TB. The evidence is strong for TB disease but less strong for TB infection and mortality. Even if the effect is relatively modest, the population-attributable risk is likely to be substantial due to the widespread nature of tobacco exposure. TB control programs must begin to address tobacco control as a potential preventive intervention. Since tobacco control will have multiple health benefits, it is likely to be a highly cost-effective intervention from a societal perspective.
烟草消费在主要健康风险中排名靠前，在吸烟问题已达到流行程度的国家，结核病是一个重大的公共卫生问题。鉴于吸烟和结核病都是主要的健康问题，并且在多个国家广泛流行，令人惊讶的是，吸烟与结核病之间的关联仍然是一个存在争议和争论的问题。尽管有几项研究评估了吸烟对结核病的影响，但结核病和公共卫生界总体上在很大程度上忽视了这种关联。最近的三项综述，包括两项荟萃分析，总结了大量已发表的关于吸烟与各种结核病结局之间关联的文献。这些综述表明，有相当多的证据表明吸烟与结核病有关。对于结核病疾病，证据很充分，但对于结核感染和死亡率，证据则不那么充分。即使这种影响相对较小，但由于烟草暴露的广泛性质，人群归因风险可能很大。结核病控制项目必须开始将烟草控制作为一种潜在的预防干预措施来应对。由于烟草控制将带来多种健康益处，从社会角度来看，它很可能是一种极具成本效益的干预措施。
