Al-Aghbari Nuha, Widyaningsih Vitri, Probandari Ari
Community Medicine Department, Faculty of Medicine and Health Sciences, University of Science and Technology, Sana'a, Yemen.
Doctoral Program of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.
BMC Public Health. 2025 Aug 6;25(1):2659. doi: 10.1186/s12889-025-23866-y.
The co-occurrence of smoking and depression presents a significant public health concern, particularly among individuals with tuberculosis (TB). Smoking delays the recovery from tuberculosis (TB) and it has also been associated with depression in those who have been diagnosed with the disease. The review aimed to find out the association between smoking and depression among TB patients.
A systematic review and meta-analysis were conducted following PRISMA guidelines, in PubMed, Scopus, and ScienceDirect databases. Literature searches were employed using terms related to "tuberculosis", "smoking," and "depression" across all articles either by title, abstract, or keywords. To evaluate the risk of bias, the Joanna Briggs Institute Critical Appraisal Checklist (JBI) was used. For clinical heterogeneity, a meta-analysis was conducted to pool estimates using RevMan 5.3 and Stata 13.0 software was used for publication bias assessment.
From the 1393 studies identified, eleven studies were eligible for inclusion in this study. There were nine cross-sectional, and two cohort studies. Only 5 studies reported effect size calculation suitable for multivariate analysis. The pooled analysis indicates that smoking TB patients were associated with a higher odds of depression (OR = 2.56, 95% CI: 1.11-5.92), though the wide confidence interval and substantial heterogeneity (I² = 71%, p = 0.003) indicates uncertainty regarding the effect size. Subgroup analysis based on depression assessment tools revealed a stronger association between smoking TB patients with depression (OR = 3.36; 95% CI: 1.19-9.50) with high heterogeneity (I² = 75%). Publication bias, as indicated by Egger's test (bias coefficient = 0.59, p = 0.874).
Existing evidence suggests a potential association between depression and smoking among tuberculosis patients, which encourages more studies to explore whether smoking cessation would contribute to the improvement of mental health outcomes in this population.
This review was developed and registered in the International Prospective Register of Systematic Reviews (PROSPERO). CRD42024528399 Registered on 06 April 2024.
吸烟与抑郁症同时存在是一个重大的公共卫生问题，在结核病患者中尤为突出。吸烟会延缓结核病的康复，并且在已确诊患有该病的人群中，吸烟也与抑郁症有关。本综述旨在探究结核病患者中吸烟与抑郁症之间的关联。
按照PRISMA指南，在PubMed、Scopus和ScienceDirect数据库中进行了系统综述和荟萃分析。通过在所有文章的标题、摘要或关键词中使用与“结核病”、“吸烟”和“抑郁症”相关的术语进行文献检索。为评估偏倚风险，使用了乔安娜·布里格斯研究所批判性评价清单（JBI）。对于临床异质性，使用RevMan 5.3进行荟萃分析以汇总估计值，并使用Stata 13.0软件进行发表偏倚评估。
从所识别的1393项研究中，有11项研究符合纳入本研究的条件。其中有9项横断面研究和2项队列研究。只有5项研究报告了适合多变量分析的效应量计算。汇总分析表明，吸烟的结核病患者患抑郁症的几率更高（OR = 2.56，95% CI：1.11 - 5.92），尽管宽置信区间和较大的异质性（I² = 71%，p = 0.003）表明效应量存在不确定性。基于抑郁症评估工具的亚组分析显示，吸烟的结核病患者与抑郁症之间的关联更强（OR = 3.36；95% CI：1.19 - 9.50），异质性较高（I² = 75%）。如Egger检验所示，不存在发表偏倚（偏倚系数 = 0.59，p = 0.874）。
现有证据表明结核病患者中抑郁症与吸烟之间存在潜在关联，这促使更多研究去探索戒烟是否有助于改善该人群的心理健康状况。
本综述在国际前瞻性系统评价注册库（PROSPERO）中制定并注册。CRD42024528399于2024年4月6日注册。
