1655. Tobacco use, tuberculosis infection, and comorbidities among tuberculosis clinic attendees in Wake County, North Carolina, 2002-2007
Session: Poster Abstract Session: Mycobacterial Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • TB and Smoking - Charles McCormick IDWeek Poster.pdf (329.5 kB)
  • Background: Tobacco smoking is associated with elevated risk of both tuberculosis (TB) infection and active pulmonary TB.  Smoking cessation interventions based in TB clinics are a potentially important strategy to increase the effectiveness of TB control programs.  To design such interventions, the epidemiology of tobacco use among TB clinic patients must be better understood.

    Methods: In this retrospective cohort study of persons attending the Wake County Human Services TB clinic between 2002-2007 (inclusive), we examined smoking prevalence in different subpopulations as well as the relationships among smoking, TB infection, and other factors that increase the risk of progression to active TB.

    Results: Of 26,702 patients screened for TB during the study period, 3,737 had additional evaluation with available demographic and comorbidity data.  The group was 50.2% female and 67.6% foreign-born.  2,156 (57.7%) had positive tuberculin skin tests.  The overall prevalence of smoking was 22.0%, which was higher than the local Wake County population smoking prevalence of 17.0% in 2005.  Smoking varied by race/ethnicity (from 10.4% for Asians to 40.8% for whites), peaked at 45-64 years (36.6%), and was more prevalent among US-born than foreign-born patients (45.9 vs. 11.2%).  Smoking was highly associated with other factors that increase risk of progression to active disease, including HIV-positive status (3.6 vs. 1.1%, p<0.0001), alcohol abuse (25.2 vs. 2.2%), p<0.0001), and diabetes mellitus (7.2 vs. 4.1%, p=0.0002).

    Conclusion: Smoking was highly prevalent in this cohort of TB clinic attendees, and it was furthermore highly associated with other conditions that increase the risk of progression to active TB.  Integrating smoking cessation into TB control programs has significant potential for public health impact, especially among high-risk populations.

    Charles Mccormick, MD, MPH, Duke University Medical Center, Durham, NC, Ashley Edwards, RN, MSN, Wake County Human Services, Raleigh, NC and Jason Stout, MD, MHS, FIDSA, Medicine, Duke University Medical Center, Durham, NC


    C. Mccormick, None

    A. Edwards, None

    J. Stout, None

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