WEDNESDAY, Feb. 28 (HealthDay News) -- People who smoke may be at higher risks for both tuberculosis infection and disease, according to a report published Feb. 26 in the Archives of Internal Medicine.
Kirk Smith, Ph.D., of the University of California, Berkeley, School of Public Health, and colleagues performed a meta-analysis of 24 published studies investigating the relationship between smoking and tuberculosis (TB) infection (six studies), TB disease (13 studies), and TB mortality (five studies).
Smoking increases the relative risk of TB infection by 73 percent (RR, 1.73), and more than doubles the risk of disease (RR, 2.33 when including ex-smokers, 2.66 when ex-smokers are excluded). The summary relative risk for TB mortality was 1.6, but as this was below the risk for disease, the authors suggest that smoking adds no additional risk for mortality. The risk of developing TB when smoking, independent of infection, is estimated to be between 1.4 and 1.6.
Based on a model in which 30 percent of the at-risk population smokes and using a relative risk of 2.5 for developing TB disease and smoking, "Simple attributable proportion calculations suggest that 31 percent of TB cases and TB deaths are attributable to smoking," the authors write. "Because worldwide there are approximately 9 million new TB cases and 1.7 million TB deaths each year, this proportion equates to an annual global burden of 2.79 million new TB cases and 527,000 deaths."
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