title: High prevalence of smoking among patients with suspected tuberculosis in South Africa.
abstract: There is growing evidence that tobacco smoking is an important risk factor for tuberculosis (TB). There are no data validating the accuracy of self-reported smoking in TB patients and limited data about the prevalence of smoking in TB patients from high-burden settings. We performed a cross-sectional analysis of 500 patients with suspected TB in Cape Town, South Africa. All underwent comprehensive diagnostic testing. The accuracy of their self-reported smoking status was determined against serum cotinine levels. Of the 424 patients included in the study, 56 and 60% of those with active and latent TB infection (LTBI), respectively, were current smokers. Using plasma cotinine as a reference standard, the sensitivity of self-reported smoking was 89%. No statistically significant association could be found between smoking and active TB or LTBI. In Cape Town, the prevalence of smoking among patients with suspected and confirmed TB was much higher than in the general South African population. Self-reporting is an accurate measure of smoking status. These results suggest the need to actively incorporate tobacco cessation programmes into TB services in South Africa.
authors.affiliation: Dept of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Brunet
authors.forename: M
authors.initials: M
authors.lastname: Pai
authors.forename: V
authors.initials: V
authors.lastname: Davids
authors.forename: D
authors.initials: D
authors.lastname: Ling
authors.forename: G
authors.initials: G
authors.lastname: Paradis
authors.forename: L
authors.initials: L
authors.lastname: Lenders
authors.forename: R
authors.initials: R
authors.lastname: Meldau
authors.forename: R
authors.initials: R
authors.lastname: van Zyl Smit
authors.forename: G
authors.initials: G
authors.lastname: Calligaro
authors.forename: B
authors.initials: B
authors.lastname: Allwood
authors.forename: R
authors.initials: R
authors.lastname: Dawson
authors.forename: K
authors.initials: K
authors.lastname: Dheda
mesh_terms: D000328:Adult; D003367:Cotinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013019:South Africa; D016896:Treatment Outcome; D014376:Tuberculosis / Q000139:chemically induced* / Q000453:epidemiology*
chemical_list: D003367:Cotinine