title: Delayed culture conversion due to cigarette smoking in active pulmonary tuberculosis patients.
abstract: Although many studies have assessed factors affecting culture conversion during tuberculosis treatment, few have looked into the effect of tobacco smoking. This study included 89 active pulmonary tuberculosis patients with positive sputum culture upon presentation and collected information regarding smoking history and culture conversion after 60 days of therapy. Current smokers had a higher risk (OR 5.6; 95%CI 1.7-18.7) of non-conversion after two months of therapy when compared to never and ex-smokers. Cavities on chest X-ray and alcohol abuse were shown to confound this association. After adjustment for cavities on the chest X-ray and alcohol abuse current smoking compared to current non-smoking remained significantly associated with culture non-conversion at 60 days of treatment (adjusted OR 6.9; 95%CI 1.8-26.7, p = 0.002) with a significant (p = 0.004) trend in adjusted OR with the number of cigarettes smoked daily to 11.6 (1.8-73.4) among those smoking more than 20 cigarettes per day. In conclusion tobacco smoking was found to delay culture conversion during treatment for pulmonary tuberculosis in a dose-dependent manner. More research is needed to elucidate the effects of smoking on tuberculosis treatment response, and of smoking cessation during tuberculosis treatment.
authors: Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands.
authors: Renee
authors: R
authors: Nijenbandring de Boer
authors: Federal Center of Technological Education Celso Suckow da Fonseca (CEFET), Rio de Janeiro, RJ, Brazil.
authors: João Baptista de
authors: JB
authors: Oliveira e Souza Filho
authors: Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: f.cobelens@aighd.org.
authors: Frank
authors: F
authors: Cobelens
authors: Tuberculosis Academic Program, Medical School/University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Daniela de Paula
authors: Dde P
authors: Ramalho
authors: Tuberculosis Academic Program, Medical School/University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Pryscilla Fernandes
authors: PF
authors: Campino Miranda
authors: Tuberculosis Academic Program, Medical School/University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Karina de
authors: Kd
authors: Logo
authors: State Hospital Santa Maria, Rio de Janeiro, Brazil.
authors: Hedi
authors: H
authors: Oliveira
authors: State Institute Ary Parreiras, Rio de Janeiro, Brazil.
authors: Eliene
authors: E
authors: Mesquita
authors: Tuberculosis Academic Program, Medical School/University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Martha Maria
authors: MM
authors: Oliveira
authors: Tuberculosis Academic Program, Medical School/University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Afrânio
authors: A
authors: Kritski
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D016017:Odds Ratio; D010349:Patient Compliance; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D000995:Antitubercular Agents
keywords: Culture conversion; Tobacco smoking; Treatment response; Tuberculosis