Pulmonary tuberculosis in smokers

<b>Introduction:</b> Tobacco smoking and tuberculosis (TB) are two major public health problems. According to the world health organization smoking substantially increases the risk of TB and death from TB. The purpose of this study is to compare clinical and radiologic aspects of TB, as well as outcome, in smokers and nonsmokers. <b>Methods:</b> We prospectively studied medical records of 130 subjects treated for TB between january 2016 and august 2017. <b>Results:</b> The mean age of our population was 45+/-17 years (range: 4- 93 years) with a male dominance (sex ratio 9.1). Seventy six patients were smokers (58.5%). An antecedent of TB and of incarceration was more frequent for these patients, respectively (84.6% vs 15.4 %, p=0.044) and (11.8% vs 0%; p=0.01). Smokers presented more frequently dry cough (56.5 vs 37%; p =0.028) but similar rate of hemoptysis than other patients (18.4 vs 9%; p=0.14). TB was pulmonary in 69.5% (n=57) of cases for smokers and 50% (n=27) for nonsmokers patients. In this form of TB, cavitation was the most common radiologic finding (43% for smokers, 22% for non smokers; p=0.01). However, mediastinal adenopathy were more frequent in the group of non smokers (70% vs 30%; p=0.05). After successful treatment, smokers presented similar frequency of radiological sequelae (11.8% vs 5.55%; p=0.14) and of recurrence rate of TB (7.8 vs 5 %; p =0.7). Neither treatment failure, nor death related to infection was noticed in our population. <b>Conclusion:</b> according to our study, smoking is not associated to a higher risk of sequelae or recurrence of TB. However, in view of multiple ravages of smoking, especially respiratory, encouraging tobacco cessation should be a part in the global management of TB.