Tobacco and tuberculosis: could we improve tuberculosis outcomes by helping patients to stop smoking?

Zellweger, Jean-Pierre; Cattamanchi, Adithya; Sotgiu, Giovanni

doi:10.1183/09031936.00221814

Cited by 23 publications

(20 citation statements)

References 19 publications

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“…Recent studies of risk factors have attributed more than 20% of global TB incidence to smoking [5]. As a result, smoking cessation is one of the interventions that can prevent TB and, among those who already developed the disease, improve its outcomes [6].While the evidence for the association between TB and tobacco provides the scientific basis for joint intervention, the global explosion in information and communication technology (ICT) presents new opportunities for more effective action on both fronts. The pace with which the coverage of internet and mobile telephone networks continues to grow, and with which the performance of electronic devices keeps advancing and diversifying, can only be described as revolutionary.…”

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confidence: 99%

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The role of eHealth and mHealth in tuberculosis and tobacco control: a WHO/ERS consultation

et al. 2015

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@ERSpublications eHealth and mHealth in tuberculosis and tobacco control: WHO/ERS consultation http://ow.ly/Owy38Both tuberculosis (TB) and tobacco consumption are major global public health concerns. About 9 million new cases of TB emerge each year and 1.5 million people die from the disease, despite the fact that TB is eminently curable in the large majority of cases with an affordable course of drugs [1]. Tobacco is the largest preventable cause of death in the world: almost 6 million people die from tobacco use and exposure each year, accounting globally for 6% of all female and 12% of all male deaths [2]. This number is set to increase to 8 million in 2030, or 10% of all deaths projected to occur that year. The burden of tobacco use is greatest in low-and middle-income countries and, unchecked, this trend is likely to increase in coming decades. There is a strong association between smoking and TB [3,4]. Smoking substantially increases the risk of contracting TB and dying from it. Recent studies of risk factors have attributed more than 20% of global TB incidence to smoking [5]. As a result, smoking cessation is one of the interventions that can prevent TB and, among those who already developed the disease, improve its outcomes [6].While the evidence for the association between TB and tobacco provides the scientific basis for joint intervention, the global explosion in information and communication technology (ICT) presents new opportunities for more effective action on both fronts. The pace with which the coverage of internet and mobile telephone networks continues to grow, and with which the performance of electronic devices keeps advancing and diversifying, can only be described as revolutionary. They create new perspectives to reach larger numbers of patients and health care workers even in resource-limited settings in the world. In fact, eHealth and mHealth open up approaches for action which would have been unimaginable a mere decade ago and a groundswell of interest has been observed in recent years to employ novel means to support TB patients [7,8]. eHealth (electronic health) is the cost-effective and secure use of ICTs for health and health-related fields while mHealth, a component of eHealth, involves the provision of health services and information via mobile technologies such as mobile phones and personal digital assistants. eHealth and mHealth are referred to collectively as "digital health". Likewise, a joint initiative between the World Health Organization (WHO) and the International Telecommunications Union, "Be He@lthy Be Mobile" (mHealth4NCD.itu.int) is seeing countries as far apart as Costa Rica, India, Norway, the Philippines, Senegal, Tunisia, the UK and Zambia embrace mHealth solutions to combat tobacco, diabetes, cervical cancer, hypertension and other non-communicable diseases. What makes this initiative unique is that these state-owned programmes use mobile phones to deliver health care at national scale rather than as pilot studies. Through its work it also supports the creation o...

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The role of eHealth and mHealth in tuberculosis and tobacco control: a WHO/ERS consultation

et al. 2015

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“…Apart from local irritation and inflammation, tobacco smoking contents are proved to decrease both cellular and humoral immunity in humans 27 . If it seems acceptable and evidence based that strengthening measures of tobacco control may have an additional and beneficial impact on tuberculosis elimination 28 , they might have an impact on the prevention of NTM pulmonary disease as well.…”

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Emerging pathology: Pulmonary disease caused by Mycobacterium xenopi - a challenge in clinical practice

Pešut

Stevic²,

Maric-Zivkovic³

et al. 2018

VOJNOSANIT PREGL

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Introduction. Human nontuberculous mycobacteria (NTM) or environmental mycobacteria related disease is on increase. Risk factors are unclear and associations are observed in relation to climate differences, population density, or host susceptibility. With availability of molecular techniques for NTM identification, we faced emergence of NTM pulmonary cases. The work is an invitation more to colleagues to enroll the rare NTM cases into large study group. Case report. During an episode of productive cough and fever in a 73-year-old HIV-negative man smoker with minimal sequellae of pulmonary tuberculosis, sputum smears were acid fast bacilli positive on direct microscopy. The Löwenstein-Jensen culture results were positive with 20, 30 and 50 colonies, and molecular identification confirmed Mycobacterium xenopi (M. xenopi). Standard chest radiography showed no signs of active lesions. Examination was completed with bronchoscopy and thorax multi-slice computed tomography (MSCT). Cavitary lesions in the apico-posterior part of the left upper lobe (LUL) were detected. Under treatment (rifampicin, ethambutol, clarithromycin) sputum conversion was achieved, but irregular cavitation in the LUL remained at MSCT after 6 and after 12 months with signs of minimal regression. Patient's general condition only mildly improved and asthenia remained. Observed risk factors were previous pulmonary disease, tobacco smoking, malnutrition and prolonged emotional stress. Conclusion. M. xenopi related pulmonary disease, difficult to cure and with uncertain prognosis, is a challenge in clinical practice. Since treatment is still controversial, more randomized clinical trials are needed. Current international multicentre approach might be a good option for a larger sample size and development of new guide.

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“…In smokers, the latent form of TB often turns into an active one, and the determining factor in this is their general health status. Smoking affects health and modifies the immune response, which favors the development of TB [4,5,6].…”

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confidence: 99%

The impact of smoking on clinical characteristics and treatment outcome of patients with pulmonary tuberculosis

Smiljic

2018

Srp Arh Celok Lek

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Intoroduction/Objective The objectives of our study were to determine the impact of smoking on clinical characteristics, the scope of radiological severity, and treatment outcome of patients with pulmonary tuberculosis (PTB). Method This prospective study included patients suffering from PTB treated at the Pulmonology Department of the Clinical Hospital Center in Kosovska Mitrovica in the period between 2010 and 2016. Results Among smokers suffering from PTB there were significantly more males (p = 0.05) between 30 and 49 years of age (p < 0.001). There was significantly more alcohol consumption present in smokers (p < 0.001), whose social factor for developing PTB (p = 0.002) was more expressed. A more severe form of PTB with cavitation was more common in smokers (38.8%), while a milder, parenchymatous, unilateral PTB was present in non-smokers (31.8%). Extensive X-ray changes were more common in smokers (p = 0.002). Relapse of the disease was more prevalent in smokers (p = 0.05). In multivariate logistic regression, the risks of being a smoker included years of age: 30-39 [odds ratio (OD) = 18.11], 40-49 (OR = 19.66), and 50-59 (OR = 9.06), and alcohol consumption habits (OR = 9.32). Conclusion Smokers were more often afflicted with sputum-positive PTB, had extensive radiological changes, and the relapse of the disease was more common. Smokers were mostly middle-aged, with alcohol consumption habits, and constructed a group of patients whose habits were a critical factor for the eradication of tuberculosis.

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Tobacco and tuberculosis: could we improve tuberculosis outcomes by helping patients to stop smoking?

Cited by 23 publications

References 19 publications

The role of eHealth and mHealth in tuberculosis and tobacco control: a WHO/ERS consultation

The role of eHealth and mHealth in tuberculosis and tobacco control: a WHO/ERS consultation

Emerging pathology: Pulmonary disease caused by Mycobacterium xenopi - a challenge in clinical practice

The impact of smoking on clinical characteristics and treatment outcome of patients with pulmonary tuberculosis

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