Special features of pulmonary tuberculosis among smokers: A case control study

Smoking and tuberculosis (TB) represent two major health issues particularly in developing countries. Tobacco consumption increases risk of Mycobaterium tuberculosis infection among immunocompetent. <b>Methods:</b> A retrospective case control study carried out in the pulmonary department of military hospital of Tunis : 173 patients treated for TB were enrolled, subdivided in tow groups (G) : G1 : 106 smokers (61.3%), G2 : 67 non smokers (38.7%) . All possible data was collected. <b>Aims:</b> To compare the clinical course and radiological aspects of pulmonary TB between smokers and non smokers. <b>Results:</b> The mean age was 43 years [18 -93 years] with a higher male rate (95.3% versus 46.3%, p&lt; 0.001) and a considerable military on active duty proportion among smokers. Risk factors for TB (Diabetes mellitus and Chronic respiratory disease) were more observed within smokers. In G1 : Cough was more frequent (81% vs 65.2%, p=0.17) as well as dyspnea (21.6% vs 4.3%, p=0.06). Radiological lesions were more extensive in smokers with more cavitations (48.6% vs 30.4%, p=0.19). No significant difference in bacillary load was observed between ever and never smokers. Therefore, sputum smear conversion delay was longer in G1 (25 versus 31 days,p=0.58). Treatment adherence was better in smokers (94% versus 80,p=0.051) with a lower rate of side effects(27.4% versus 34.2%, p=0.12) and higher percentage of persistent sequels . It is clear that tobacco consumption is a avoidable risk factor for TB. The integration of smoking cessation should be a part of the strategy to control the higher burden of TB in developing countries.