ArticlePloS one2019
Smoking, alcohol use disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be ignored.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 39 papers, 5 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Factors associated with severity of pulmonary tuberculosis in people living with and without HIV: a systematic review.BMC infectious diseases · 2026Pooled it
- Pooled it
- Magnitude and determinants of alcohol use disorder among adult population in East Asian countries: A systematic review and meta-analysis.Frontiers in public health · 2023Pooled it
- Prevalence and associated factors for alcohol use disorder among tuberculosis patients: a systematic review and meta-analysis study.Substance abuse treatment, prevention, and policy · 2021Pooled it
- Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis.PloS one · 2019Pooled it
- Trial
- Prevalence and factors associated with tuberculosis recurrence among key vulnerable populations in the Ashanti region, Ghana.BMC infectious diseases · 2026Article
- Incidence and predictors of tuberculosis among adult diabetes mellitus patients in western Amhara comprehensive specialized hospitals, northwest Ethiopia. A multicenter retrospective follow-up study.Journal of public health research · 2026Article
- Article
- Bacterial distribution and drug resistance patterns of urinary tract infection in tuberculosis patients: a 5-year retrospective study.Frontiers in microbiology · 2026Article
- Impact of Nutritional Counselling and Support on Body Mass Index Recovery and Treatment Outcomes Among Tuberculosis Patients in the Lao People's Democratic Republic.Tropical medicine and infectious disease · 2025Article
- Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023.BMC infectious diseases · 2025Article
- Finding the missing men with tuberculosis: a participatory approach to identify priority interventions in Uganda.Health policy and planning · 2025Article
- From pandemic to endemic: assessing the impact of COVID-19 history and socio-demographic factors on quality of life in tuberculosis patients.Frontiers in medicine · 2025Article
- Assessment of comorbidities, risk factors, and post tuberculosis lung disease in National Tuberculosis Guidelines: A scoping review.PLOS global public health · 2025Article
- Association between alcohol consumption and risk of developing tuberculosis in patients with diabetes: a nationwide retrospective cohort study.Respiratory research · 2024Article
- Alcohol use disorder research in India: An update.Indian journal of psychiatry · 2024Review
- Effectiveness of smoking cessation intervention based on the ABC Approach in patients with TB.Public health action · 2024Article
- Clinical and laboratory risk factors for pulmonary tuberculosis recurrence in three pooled Indian cohorts.Frontiers in tuberculosis · 2024Article
- Disease burden of tuberculosis in China from 1990 to 2021 and its prediction to 2036.Frontiers in public health · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
24 authors.
Funding
Abstract
backgroundMore than 20% of tuberculosis (TB) disease worldwide may be attributable to smoking and alcohol abuse. India is the second largest consumer of tobacco products, a major consumer of alcohol particularly among males, and has the highest burden of TB globally. The impact of increasing tobacco dose, relevance of alcohol misuse and past versus current or never smoking status on TB treatment outcomes remain inadequately defined.
methodsWe conducted a multi-centric prospective cohort study of newly diagnosed adult pulmonary TB patients initiated on TB treatment and followed for a minimum of 6 months to assess the impact of smoking status with or without alcohol abuse on treatment outcomes. Smokers were defined as never smokers, past smokers or current smokers. Alcohol Use Disorder Identification Test (AUDIT) scores were used to assess alcohol misuse. The association between smoking status and treatment outcomes was assessed in univariate and multivariate random effects poisson regression models.
resultsOf 455 enrolled, 129 (28%) had a history of smoking with 94 (20%) current smokers and 35 (8%) past smokers. Unfavourable treatment outcomes were significantly higher among past and current smokers as compared to never smokers. Specifically, the risk of treatment failure was significantly higher among past smokers (aIRR = 2.66, 95% CI: 1.41-4.90, p = 0.002), recurrent TB among current smokers (aIRR = 2.94, 95% CI: 1.30-6.67, p = 0.010) and death among both past (2.63, 95% CI: 1.11-6.24, p = 0.028) and current (aIRR = 2.59, 95% CI: 1.29-5.18, p = 0.007) smokers. Furthermore, the combined effect of alcohol misuse and smoking on unfavorable treatment outcomes was significantly higher among past smokers (aIRR: 4.67, 95% CI: 2.17-10.02, p<0.001) and current smokers (aIRR: 3.58, 95% CI: 1.89-6.76, p<0.001).
conclusionPast and current smoking along with alcohol misuse have combined effects on increasing the risk of unfavourable TB treatment outcomes. Innovative interventions that can readily address both co-morbidities are urgently needed.
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