Instituto Nacional de Salud Pública, Ave. Universidad #655, Col. Sta. María Ahuacatitlán, Cuernavaca, C.P. 62100Morelos, México.
J Infect. 2013 Apr;66(4):303-12. doi: 10.1016/j.jinf.2012.09.005. Epub 2012 Sep 12.
To examine the relationship between cigarette smoking and incidence and mortality rates of pulmonary tuberculosis (TB) and treatment outcomes.
From 1995 to 2010, we analyzed data from 1062 patients with TB and from 2001 to 2004, 2951 contacts in Southern Mexico. Patients with acid-fast bacilli or Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and mycobacteriological evaluation and received treatment by the local DOTS program.
Consumers of 1-10 (LS) or 11 or more (HS) cigarettes per day incidence (1.75 and 11.79) and mortality (HS, 17.74) smoker-non-smoker rate ratios were significantly higher for smokers. Smoker population was more likely to experience unfavorable treatment outcomes (HS, adjusted OR 2.36) and retreatment (LS and HS, adjusted hazard ratio (HR) 2.14 and 2.37). Contacts that smoked had a higher probability of developing active TB (HR 2.38) during follow up.
Results indicate the need of incorporating smoking prevention and cessation, especially among men, into international TB control strategies.
探讨吸烟与肺结核（TB）发病率和死亡率以及治疗结果之间的关系。
我们分析了 1995 年至 2010 年间来自墨西哥南部 1062 名肺结核患者和 2001 年至 2004 年间 2951 名接触者的数据。痰样本中存在抗酸杆菌或结核分枝杆菌的患者接受了流行病学、临床和分枝杆菌学评估，并接受了当地 DOTS 计划的治疗。
每天吸烟 1-10 支（LS）或 11 支或更多（HS）的消费者，发病率（HS，17.74）和死亡率（HS，17.74）的吸烟者-非吸烟者比率显著更高。吸烟者更有可能出现不良治疗结果（HS，调整后的比值比 2.36）和复发（LS 和 HS，调整后的危险比 HR 2.14 和 2.37）。在随访期间，吸烟的接触者发生活动性肺结核（HR 2.38）的概率更高。
结果表明需要将吸烟预防和戒烟纳入国际结核病控制策略中，尤其是针对男性。
