BACKGROUNDTuberculosis is an infectious disease caused by Mycobacterium tuberculosis which spreads by inhalation of infected droplet nuclei. Prevalence of TB is three times higher among ever-smokers as compared to that of never smokers. Mortality from TB is three to four times higher among ever-smokers as compared to never smokers. Smoking contributes to 50% of male deaths from TB in India in the 25-69 years age group. We performed a prospective study over one and half year period with objective of comparing the sputum conversion, clinical and radiological presentation, in smokers and non-smokers in newly diagnosed sputum positive pulmonary tuberculosis patients started on anti-tuberculosis treatment. METHODSThis prospective observational study was done on the adult newly diagnosed sputum positive (micro biologically confirmed) pulmonary tuberculosis patients started on anti-tuberculosis therapy in the Department of Pulmonary Medicine, Gandhi Hospital, Secunderabad. This study was performed over a period of 18 months. A comparative analysis of sputum conversion, clinical and radiological presentation between smokers and non-smokers in newly diagnosed sputum positive pulmonary tuberculosis patients who were on anti-tuberculosis treatment was carried out. RESULTSIn the present study, 100 patients were seen during the study period, and divided into 2 groups comprising of 50 smokers and 50 non-smokers who were diagnosed as newly sputum positive pulmonary tuberculosis. Overall mean age in the present study was 40.34 years and in smokers groups mean age is 49.44 years and among non-smokers it is 31.21 years. Among non-smokers, females contribute 46% and male accounted for 54%. CONCLUSIONSSmoking is associated with delayed sputum conversion, more complications like hemoptysis, more advanced and extensive lesions radiologically. Hence, smokers pose an epidemiological threat by remaining infective as they remain a source of infection for longer period of time. Hence smoking should be enquired into and discouraged in all patients. This study can be made extensive by increasing the size of the sample, by examining the sputum smear for AFB at 15 days intervals, and by following up the patients to look for relapse in patients who have quit smoking and in patients who have continued to do so.