Tobacco smoking: a major risk factor for pulmonary tuberculosis--evidence from a cross-sectional study in central India.

BACKGROUND

This paper provides information on the association of tobacco smoking and alcohol consumption with pulmonary TB (PTB) in central India.

METHODS

A community based cross-sectional TB prevalence survey was conducted in Jabalpur district of the central Indian state of Madhya Pradesh. The information on tobacco smoking and alcohol consumption was collected from individuals aged ≥15 years. Using logistic regression analysis, the risk factors for PTB were identified.

RESULTS

A total of 94 559 individuals provided information on tobacco smoking and alcohol consumption. Persons aged 35-54 years and 55 years and above had, respectively, a 2.19 (95% CI 1.57-3.07) and a 3.26 (95% CI 2.23-4.77) times higher risk of developing PTB compared to persons aged below 35 years. Males had a 2.35 (95% CI 1.66-3.32) times higher risk than females. Tribals (indigenous population) had a 2.32 (95% CI 1.68-3.21) times higher risk than non-tribal population. The adjusted prevalence odds ratio for mild, moderate and heavy tobacco smokers were 2.28, 2.51 and 2.74 respectively as compared to non-smokers. Alcohol consumption was not found to be a risk factor on multivariate analysis.

CONCLUSION

Tobacco smoking is significantly associated with PTB in this central Indian district. Smoking cessation services need to be integrated into the activities of the TB control programme.