Editor's Correspondence |

Smoking and Tuberculosis: Infection, Disease, and Mortality

Chi Chiu Leung, MBBS; Tai Hing Lam, MD; Wing Wai Yew, MBBS
Arch Intern Med. 2007;167(18):2008-2009. doi:10.1001/archinte.167.18.2008-b.
Text Size: A A A
Published online


We read with great interest the recent meta-analysis by Bates et al1 on the risk of tuberculosis from exposure to tobacco smoke.1 Because both smoking and tuberculosis are still major killers, especially in developing countries, such a meta-analysis has been long awaited. However, a few points might warrant further discussion.

In the analysis by Bates et al,1 smoking increases the relative risk (RR) of both tuberculosis infection (RR, 1.73, as measured by a positive tuberculin skin test [TST] result) and disease (RR, 2.33-2.66), and the authors therefore estimated the net RR for disease development in an infected population to be 1.4 to 1.6. However, the only cohort study included by Bates et al1 for the analysis of disease development refers to elderly subjects in Hong Kong.1,2 With the huge past burden of tuberculosis, a very high background prevalence of tuberculosis infection is expected in that cohort.2,3 The additional effect of smoking on infection prevalence should be minimal, but the RR for tuberculosis disease remained high, especially for culture-confirmed tuberculosis among the male subjects (unadjusted RR, 2.24 and 3.49 for ex-smokers and current smokers, respectively).2

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles