Original article
Cigarette smoking as a risk factor for tuberculosis in young adults: A casecontrol study

https://doi.org/10.1016/S0962-8479(96)90024-6Get rights and content

Abstract

Setting: The association between smoking and pulmonary tuberculosis has not often been studied.

Objective: To assess the influence of cigarette smoking on the development of active pulmonary tuberculosis in young people who were close contacts of new cases of smear-positive pulmonary tuberculosis.

Design: A case-control study in which 46 ‘cases’ (patients with active pulmonary tuberculosis: isolation of Mycobacterium tuberculosis or clinical and/or radiographic evidence of current pulmonary tuberculosis, with a positive tuberculin skin test) and 46 ‘controls’ (persons with positive tuberculin reaction, negative bacteriological test and without clinical and/or radiological evidence of pulmonary tuberculosis) were included. Smoking habits were investigated by questionnaire. Univariate and multivariate analysis was performed, and odds ratio (OR) was adjusted for age, gender and socio-economic status.

Results: Statistically significant differences were found in active smokers (occasional and daily smokers) (OR: 3.65; 95% CI, 1.46 and 9.21; P < 0.01), daily smokers (OR: 3.53; 95% CI, 1.34 and 9.26; P < 0.05), and individuals who were both passive and active smokers (OR: 5.10; 95 % CI, 1.97 and 13.22; P < 0.01) and passive and daily smokers (OR: 5.59; 95% CI, 2.07 and 15.10; P < 0.001). There was a dose-response relationship between the number of cigarettes smoked daily and the risk of active pulmonary tuberculosis.

Conclusions: The data studied show that cigarette smoking is a risk factor for pulmonary tuberculosis in young people, with a dose-response relationship with the number of cigarettes consumed daily.

Résumé

Cadre: L'association entre le tabagisme et la tuberculose pulmonaire n'a pas souvent été étudiée.

Objet: Evaluer l'influence du tabagisme sur la progression d'une tuberculose pulmonaire active chez des sujets jeunes, contacts de nouveaux cas de tuberculose pulmonaire frottis positif.

Schéma: Celui-ci comprend l'étude de cas et de leurs témoins portant sur 46 cas (malades atteints d'une tuberculose pulmonaire active: Mycobacterium tuberculosis isolé ou preuve clinique et/ou radiographique d'une tuberculose pulmonaire commune avec un test tuberculinique positif) et 46 témoins (individus ayant une réaction tuberculinique positive, une culture négative et sans preuve clinique et/ou radiologique de tuberculose). Les habitudes de tabagisme étaient étudiées par questionnaire. Des analyses univariées et multivariées ont été effectuées. L'odds ratio (OR) a été ajusté pour les facteurs âge, sexe et niveau socio-économique.

Resultats: Des différences statistiquement significatives ont été trouvées chez les fumeurs actifs (fumeurs occasionnels ou quotidiens) (OR 3,65; 95% IC 1,46 et 9,21; P < 0,01), les fumeurs quotidiens (OR 3,53; 95% IC 1,34 et 9,26; P < 0,05) et les individus qui étaient à la fois des fumeurs passifs et actifs (OR 5,10; 95% IC 1,97 et 13,22; P < 0,01) et les fumeurs passifs et quotidiens (OR 5,59; 95% IC 2,07 et 15,10; P < 0,001). II existait une relation dose-réponse entre le nombre de cigarettes consommées chaque jour et le risque de tuberculose pulmonaire active.

Conclusion: Les données étudiées montre que le tabagisme est un facteur de risque pour la tuberculose pulmonaire chez les jeunes gens, avec une relation dose-réponse associée au nombre de cigarettes consommées chaque jour.

Resumen

Marco de referencia: La asociación entre tabaquismo y tuberculosis pulmonar no ha sido estudiada frecuentemente.

Objetivo: Evaluar la influencia del tabaquismo en el desarrollo de la tuberculosis pulmonar activa en jóvenes que han estado en estrecho contacto con pacientes que presentan tuberculosis pulmonar con baciloscopia positiva.

Método: Un estudio de casos-control en el cual se incluyeron 46 ‘casos’ (pacientes con tuberculosis pulmonar activa: identificación de Mycobacterium tuberculosis o evidencia clínica y/o radiológica de tuberculosis pulmonar con un test de tuberculina positivo) y 46 ‘controles’ (personas con una reacción de tuberculina positiva, estudios bacteriológicos negativos y sin evidencia clínica y/o radiológica de tuberculosis pulmonar). Las características del tabaquismo fueron estudiadas mediante un cuestionario. Se efectuó un análisis mono y multiparamétrico. El ‘Odds Ratio’ (OR) fue ajustado según la edad, el sexo y el nivel socio-económico.

Resultados: Se observaron diferencias estadísticamente significativas entre los fumadores activos (fumadores ocasionales y cotidianos) (OR: 3,65; 95 % IC, 1,46 y 9,21; P < 0,01), los fumadores cotidianos (OR: 3,53; 95 % IC, 1,34 y 9,26; P < 0,05) y los individuos que eran tanto fumadores activos como pasivos (OR: 5,1; 95% IC, 1,97 y 13,22; P < 0,01) así como con los fumadores pasivos y cotidianos (OR: 5,59; 95% IC, 2,07 y 15,1; P < 0,001). Se observó una relación dosis-respuesta entre el número de cigarrillos que la persona fumaba diariamente y el riesgo de tuberculosis pulmonar activa.

Conclusiones: Los datos analizados demuestran que el tabaquismo constituye un factor de riesgo de tuberculosis pulmonar en los jóvenes, con una relación dosis-respuesta asociada al número de cigarrillos fumados diariamente.

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