title: Tobacco smoking and tuberculosis treatment outcomes: a prospective cohort study in Georgia.
abstract: OBJECTIVE
  To assess the effect of tobacco smoking on the outcome of tuberculosis treatment in Tbilisi, Georgia.
  
  
  METHODS
  We conducted a prospective cohort study of adults with laboratory-confirmed tuberculosis from May 2011 to November 2013. History of tobacco smoking was collected using a standardized questionnaire adapted from the global adult tobacco survey. We considered tuberculosis therapy to have a poor outcome if participants defaulted, failed treatment or died. We used multivariable regressions to estimate the risk of a poor treatment outcome.
  
  
  RESULTS
  Of the 591 tuberculosis patients enrolled, 188 (31.8%) were past smokers and 271 (45.9%) were current smokers. Ninety (33.2%) of the current smokers and 24 (18.2%) of the participants who had never smoked had previously been treated for tuberculosis (P < 0.01). Treatment outcome data were available for 524 of the participants, of whom 128 (24.4%) - including 80 (32.9%) of the 243 current smokers and 21 (17.2%) of the 122 individuals who had never smoked - had a poor treatment outcome. Compared with those who had never smoked, current smokers had an increased risk of poor treatment outcome (adjusted relative risk, aRR: 1.70; 95% confidence interval, CI: 1.00-2.90). Those who had ceased smoking more than two months before enrolment did not have such an increased risk (aRR: 1.01; 95% CI: 0.51-1.99).
  
  
  CONCLUSIONS
  There is a high prevalence of smoking among patients with tuberculosis in Georgia and smoking increases the risk of a poor treatment outcome.
authors.affiliation: University Research Company LLC Branch in Georgia, United States Agency for International Development Georgia Tuberculosis Prevention Project, Tbilisi, Georgia .
authors.forename: Medea
authors.initials: M
authors.lastname: Gegia
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, One Park Place NE, Atlanta, GA 30303, United States of America (USA).
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Magee
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, USA .
authors.forename: Russell R
authors.initials: RR
authors.lastname: Kempker
authors.affiliation: Gudushauri National Medical Centre, Tbilisi, Georgia .
authors.forename: Iagor
authors.initials: I
authors.lastname: Kalandadze
authors.affiliation: University Research Company LLC Branch in Georgia, United States Agency for International Development Georgia Tuberculosis Prevention Project, Tbilisi, Georgia .
authors.forename: Tsira
authors.initials: T
authors.lastname: Chakhaia
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, USA .
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Golub
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, USA .
authors.forename: Henry M
authors.initials: HM
authors.lastname: Blumberg
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult