12 December 2007

Smoking may increase TB risk

If you smoke, you might be at increased risk of tuberculosis, a new South African study suggests.

If you smoke, you might be at increased risk of tuberculosis, a new South African study suggests.

"We found that the risk of tuberculosis infection is increased if you smoke," said lead researcher Saskia den Boon, from the Desmond Tutu TB Centre, Department of Paediatrics and Child Health at Stellenbosch University.

"This is one of the first papers showing an association between smoking and risk for tuberculosis infection," added study co-author Dr Nulda Beyers, also from Stellenbosch University.

The researchers surveyed 2 401 adults from two communities in South Africa. They asked how much each person smoked and they also administered a skin test to identify tuberculosis.

Strong correlation between smoking and TB
Den Boon's team found that among 1 309 current and former smokers, 82 percent tested positive for tuberculosis. In addition, the researchers found that the longer one smoked, the greater the risk of tuberculosis.

The report appears in the July issue of Thorax.

"The reason for the increased risk of infection in smokers is unclear," Den Boon's team wrote. They speculate that it may have something to do with the effect of smoking on the lung's ability to fight infection.

The link is worth investigating
While they did not prove a causal relationship between smoking and tuberculosis, the researchers believe it is something worth investigating.

"These are two things [smoking and tuberculosis] happening in poor countries, and both are preventable," Beyers said. "Perhaps if one is more active with smoking-cessation programs, then that can help. We need to think differently, and not think only smoking and lung cancer. In poor countries, we must think smoking and tuberculosis."

Tuberculosis is a potentially fatal disease caused by bacteria called Mycobacterium tuberculosis that usually attack the lungs.

Other factors may have impacted findings
One tuberculosis expert found the study intriguing, but suggested that other factors may be at play.

"This is an interesting finding suggesting that smoking may be a risk factor for latent tuberculosis infection," said Dr Jean Nachega, a research associate from the Johns Hopkins Centre for Tuberculosis Research.

"However, one major limitation of the study is that this finding may have been confounded by HIV infection, which is known to be a major risk factor for tuberculosis in a country such as South Africa, where TB/HIV co-infection is highly prevalent," she added.

Another Johns Hopkins expert offered a different explanation for the finding.

"Smoking is often done in bars in South Africa, so it could be a marker for exposure to tuberculosis in these crowded areas," said Dr Richard E. Chaisson, a professor of medicine and director of the Johns Hopkins University Centre for Tuberculosis Research.

‘One more reason not to smoke’
Nonetheless, Dr Norman H. Edelman, chief medical officer of the American Lung Association and dean of the School of Medicine at the State University of New York at Stony Brook, said the new study was one more reason not to smoke.

"If you make a list of why smoking is bad for you, it runs three pages, and this is on the list," he said.

Poor lung function linked to cancer risk
Another study in the same issue of the journal found that people with poor lung function have an increased risk of lung cancer.

Dr Don Sin, of the Centre for Cardiovascular and Pulmonary Research at St. Paul's Hospital, Vancouver, Canada, and colleagues looked at data from four studies that examined the relationship between lung function and lung cancer.

Among 204 990 participants in these studies, 6 185 had lung cancer or died from the disease. The researchers found that for men who had the worst lung function, the risk of developing lung cancer was more than twice that of people with the best lung function. For women, the risk was almost four times as high.

Since even small changes in lung function can signal a chance of lung cancer, Sin's group thinks its finding might be useful in screening people to detect cancer at its earliest stages, when it is most likely to be cured. – (HealthDayNews)

June 2006

For more information on care and support of tuberculosis visit South African National TB Association (SANTA) or phone them on 011 454 0260.


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