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Review of cigarette smoking and tuberculosis in China: intervention is needed for smoking cessation among tuberculosis patients.

Wang J, Shen H - BMC Public Health (2009)

Bottom Line: The proportion of cigarette smoking was 54.6% in TB cases, which was significantly higher than that in controls (45.1%) with adjusted OR of 1.93(95% CI: 1.51-2.48).In the Cox regression estimates adjusted for age and gender, compared with those highly educated and previously treated patients, the hazard ratios of smoking relapse were 3.48(95% CI: 1.28-9.47) for less educated (<6 years) and 4.30(95% CI: 1.01-18.30) for newly treated patients, respectively.Cigarette smoking is associated with TB in the Chinese.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, PR China. merry21st@yahoo.com.cn

ABSTRACT

Background: As a risk factor of tuberculosis (TB), tobacco smoking has increased substantially over the past three decades, especially in developing countries. However, the association between smoking and TB, which has been shown to exist in different studies with different ethnic background, has not yet received sufficient attention in terms of TB care standards and research in China.

Methods: An observational study was conducted in two rural areas of China. A total of 613 TB patients frequency matched with 1226 controls were interviewed by using a structured questionnaire. The associations between cigarette smoking and risk of TB were estimated by computing odds ratios (ORs) and 95% confidence intervals (95% CIs) from logistic regression model. Patients' smoking behavior and patterns of smoking cessation were followed after TB diagnosis. Multivariate Cox proportional hazards model was applied to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) in analyzing the risk factors for smoking relapse. The Kaplan-Meier estimate was computed to plot the ability of smoking-free after cessation among different groups, with the Log-rank test being used to compare the difference.

Results: The proportion of cigarette smoking was 54.6% in TB cases, which was significantly higher than that in controls (45.1%) with adjusted OR of 1.93(95% CI: 1.51-2.48). Though 54.9% smokers stopped smoking after being diagnosed with TB, more than 18% relapsed during the follow-up period. The proportion of relapse was higher within 6-9 months (6%) and 12-15 months (11%) after cessation. In the Cox regression estimates adjusted for age and gender, compared with those highly educated and previously treated patients, the hazard ratios of smoking relapse were 3.48(95% CI: 1.28-9.47) for less educated (<6 years) and 4.30(95% CI: 1.01-18.30) for newly treated patients, respectively.

Conclusion: Cigarette smoking is associated with TB in the Chinese. Interventions of smoking cessation are recommended to be included in the current TB control practice.

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Kaplan-Meier survival estimates for patients with different treatment history in the risk of smoking relapse.
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Figure 2: Kaplan-Meier survival estimates for patients with different treatment history in the risk of smoking relapse.

Mentions: Though 54.9% smokers stopped smoking after being diagnosed with TB, more than 18% of quitters relapsed again during the follow-up period (the mean duration of follow-up was 1.35 years, ranging from 3 months to 49 months). The proportions of smoking relapse were 0, 0.01, 0.06, 0.02 and 0.11 at the time period of 0–3, 3–6, 6–9, 9–12 and 12–15 months, respectively. The Kaplan-Meier survival estimates for smoking-free after cessation among patients with different treatment history and education level were shown in Figure 2 (Log-rank test: P = 0.042) and Figure 3 (Log-rank test: P = 0.002), respectively. In the Cox regression estimates adjusted for age and gender, compared with those highly educated and previously treated patients, the hazard ratios of smoking relapse were 3.48 (95% CI: 1.28–9.47) for less educated (< 6 years) and 4.30 (95% CI: 1.01–18.30) for newly treated patients, respectively (Table 4).


Review of cigarette smoking and tuberculosis in China: intervention is needed for smoking cessation among tuberculosis patients.

Wang J, Shen H - BMC Public Health (2009)

Kaplan-Meier survival estimates for patients with different treatment history in the risk of smoking relapse.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2734854&req=5

Figure 2: Kaplan-Meier survival estimates for patients with different treatment history in the risk of smoking relapse.
Mentions: Though 54.9% smokers stopped smoking after being diagnosed with TB, more than 18% of quitters relapsed again during the follow-up period (the mean duration of follow-up was 1.35 years, ranging from 3 months to 49 months). The proportions of smoking relapse were 0, 0.01, 0.06, 0.02 and 0.11 at the time period of 0–3, 3–6, 6–9, 9–12 and 12–15 months, respectively. The Kaplan-Meier survival estimates for smoking-free after cessation among patients with different treatment history and education level were shown in Figure 2 (Log-rank test: P = 0.042) and Figure 3 (Log-rank test: P = 0.002), respectively. In the Cox regression estimates adjusted for age and gender, compared with those highly educated and previously treated patients, the hazard ratios of smoking relapse were 3.48 (95% CI: 1.28–9.47) for less educated (< 6 years) and 4.30 (95% CI: 1.01–18.30) for newly treated patients, respectively (Table 4).

Bottom Line: The proportion of cigarette smoking was 54.6% in TB cases, which was significantly higher than that in controls (45.1%) with adjusted OR of 1.93(95% CI: 1.51-2.48).In the Cox regression estimates adjusted for age and gender, compared with those highly educated and previously treated patients, the hazard ratios of smoking relapse were 3.48(95% CI: 1.28-9.47) for less educated (<6 years) and 4.30(95% CI: 1.01-18.30) for newly treated patients, respectively.Cigarette smoking is associated with TB in the Chinese.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, PR China. merry21st@yahoo.com.cn

ABSTRACT

Background: As a risk factor of tuberculosis (TB), tobacco smoking has increased substantially over the past three decades, especially in developing countries. However, the association between smoking and TB, which has been shown to exist in different studies with different ethnic background, has not yet received sufficient attention in terms of TB care standards and research in China.

Methods: An observational study was conducted in two rural areas of China. A total of 613 TB patients frequency matched with 1226 controls were interviewed by using a structured questionnaire. The associations between cigarette smoking and risk of TB were estimated by computing odds ratios (ORs) and 95% confidence intervals (95% CIs) from logistic regression model. Patients' smoking behavior and patterns of smoking cessation were followed after TB diagnosis. Multivariate Cox proportional hazards model was applied to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) in analyzing the risk factors for smoking relapse. The Kaplan-Meier estimate was computed to plot the ability of smoking-free after cessation among different groups, with the Log-rank test being used to compare the difference.

Results: The proportion of cigarette smoking was 54.6% in TB cases, which was significantly higher than that in controls (45.1%) with adjusted OR of 1.93(95% CI: 1.51-2.48). Though 54.9% smokers stopped smoking after being diagnosed with TB, more than 18% relapsed during the follow-up period. The proportion of relapse was higher within 6-9 months (6%) and 12-15 months (11%) after cessation. In the Cox regression estimates adjusted for age and gender, compared with those highly educated and previously treated patients, the hazard ratios of smoking relapse were 3.48(95% CI: 1.28-9.47) for less educated (<6 years) and 4.30(95% CI: 1.01-18.30) for newly treated patients, respectively.

Conclusion: Cigarette smoking is associated with TB in the Chinese. Interventions of smoking cessation are recommended to be included in the current TB control practice.

Show MeSH
Related in: MedlinePlus