TUBERCULOSIS

Association between smoking and tuberculosis infection: a population survey in a high tuberculosis incidence area

S den Boon^1,2, S W P van Lill¹, M W Borgdorff^2,3, S Verver³, E D Bateman⁴, C J Lombard⁵, D A Enarson⁶, N Beyers¹

¹ Centre for TB Research and Education, Department of Paediatrics and Child Health, Stellenbosch University, P O Box 19063, 7505 Tygerberg, Cape Town, South Africa
² Academic Medical Centre, Amsterdam, The Netherlands
³ KNCV Tuberculosis Foundation, The Hague, The Netherlands
⁴ Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa
⁵ Biostatistics Unit, Medical Research Council, Cape Town, South Africa
⁶ International Union Against Tuberculosis and Lung Diseases, Paris, France

Correspondence to:
Correspondence to:
MsS den Boon
Centre for TB Research and Education, Department of Paediatrics and Child Health, Stellenbosch University, P O Box 19063, 7505 Tygerberg, Cape Town, South Africa; 14321823{at}sun.ac.za

Background: Associations between smoking and tuberculosis disease including death from tuberculosis have been reported, but there are few reports on the influence of smoking on the risk of developing Mycobacterium tuberculosis infection. The aim of this study was to determine the association between smoking and M tuberculosis infection.

Methods: In a cross sectional population survey, data on smoking and tuberculin skin test (TST) results of 2401 adults aged 15 years were compared.

Results: A total of 1832 (76%) subjects had a positive TST (10 mm induration). Of 1309 current smokers or ex-smokers, 1070 (82%) had a positive TST. This was significantly higher than for never smokers (unadjusted OR 1.99, 95% confidence interval (CI) 1.62 to 2.45). A positive relationship with pack-years was observed, with those smoking more than 15 pack-years having the highest risk (adjusted OR 1.90, 95% CI 1.28 to 2.81).

Conclusion: Smoking may increase the risk of M tuberculosis infection.

Keywords: tuberculosis; infection; smoking; tuberculin skin test

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