EDITORIAL

Smoking and tuberculosis

Smoking and tuberculosis: a chance or causal association?

G H Bothamley

Correspondence to:
Correspondence to:
Dr G H Bothamley
NE London TB Network, Homerton University Hospital, London E9 6SR, UK; graham.bothamley@homerton.nhs.uk

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Possible explanations for the association between smoking and tuberculosis

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Keywords: smoking; tuberculosis; infection

The first 150 words of the full text of this article appear below.

In 1956 Doll and Hill¹ wrote that "the relationship between smoking and mortality from pulmonary tuberculosis is distinct, but with a disease so influenced by social factors more precise data are needed to justify a direct cause and effect hypothesis".

The essential risk factors for human tuberculosis are (1) the tubercle bacillus, (2) a susceptible host, and (3) an environment which allows the tubercle bacilli to survive transit from one host to the next. All other risk factors are subsumed under these headings. If smoking is a risk factor for tuberculosis, then it must act by increasing the susceptibility of the human host or the probability of transmission by encouraging infectious individuals to cough (this requires smoking to be a social as much as an individual pursuit). If the association between smoking and tuberculosis is more apparent than real, then smoking may be a pointer . . . [Full text of this article]

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