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Global tobacco TB risk

Wednesday October 5th, 2011

Smoking could substantially increase deaths from tuberculosis around the world, say public health experts.

The number of smokers in poor countries is expected to rise, bringing a raised risk of tuberculosis (TB) infection. So a team led by Dr Sanjay Basu of the University of California, San Francisco, USA, looked at population-wide TB rates.

They devised a mathematical model of TB epidemics to estimate the impact of different possible future smoking trends.

If smoking trends continue as they are now, the model predicted that smoking would cause 18 million TB cases and 40 million TB deaths between 2010 and 2050.

Smoking would increase the number of TB cases by seven per cent, from 256 million to 274 million, and increase deaths by 66 per cent from 61 million to 101 million. It would also delay the millennium development goal target to reduce TB mortality by half from 1990 to 2015.

On the other hand, aggressive tobacco control achieving a one per cent fall in smoking each year could prevent 27 million smoking attributable deaths from TB by 2050. This rate has been achieved in some US states.

The study is published on the website of the British Medical Journal.

"Tobacco smoking could substantially increase TB cases and deaths worldwide in coming years, undermining progress towards TB mortality targets," the authors write. "Aggressive tobacco control could avert millions of deaths from TB."

They point out that passive smoking "could greatly amplify the number of TB cases attributable to smoking". But "few studies have reviewed the effect of passive smoking on TB, and the subject merits further investigation".

Basu, S. et al. Projected effects of tobacco smoking on worldwide tuberculosis control: mathematical modelling analysis. The British Medical Journal, 2011;343:d550.

Tags: Drug and Alcohol Abuse | Respiratory | World Health

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