Smoking is an independent risk factor for both quiescent TB infection and the development of active TB, according to a new systematic review and meta-analysis.
To quantify the relationship between smoking and TB, pulmonary disease, and mortality, researchers at the University of California, Berkeley, analyzed data from 24 published studies. They found that smokers have a 73% greater chance of becoming infected with Mycobacterium tuberculosis than nonsmokers. For people infected with TB, the chances of developing active disease are about 50% greater in smokers than in nonsmokers. Extrapolating from the data, the researchers said that smoking may be responsible for more than 30% of TB cases and deaths.
However, they add that it is not clear at this point whether smoking further increases the risk of death in people who already have TB.
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Because smoking is potentially one of the most modifiable risk factors for TB, the authors concluded that “smoking prevention and cessation efforts should be a priority in any TB prevention program” (Arch Intern Med. 2007; 167:335-342).
