Tobacco and TB on a collision course

Clarity Sibanda, CNS Correspondent, Zimbabwe
Photo credit: CNS
Tobacco smoking is taking a toll on the lives of many people the world over--not only is it threatening their health but their livelihoods as well, since the money meant for their development is diverted to purchasing cigarettes. Hence anti-smoking strategies are needed since the disease is a modifiable risk factor common to both TB and HIV. “Smoking is more prevalent among people with TB or HIV and is associated with TB infection, TB disease, and poorer outcomes for TB treatment. People living with HIV are at a greater risk from tobacco-related diseases and smoking may also inhibit the effectiveness of life-saving antiretroviral therapies.

By incorporating a set of practical measures into everyday practice the treatment outcomes of men, women and children with TB and HIV can be improved,” said Dr Angela Jackson-Morris, lead author of a recent study published in the International Journal of Tuberculosis and Lung Disease, calling for urgent action to integrate anti-smoking strategies into TB, HIV and TB-HIV care.

According to Angela “We are failing people with TB and HIV if we treat smoking as a ‘to do later’ issue. Practitioners and policymakers urgently need to address smoking as part of their care for people with HIV and TB.”

Tobacco and TB are on a collision course. Understanding the impact of smoking on TB treatment outcomes is critically important. If we want to control TB more work needs to be done to elucidate the mechanisms underlying the impact of smoking on TB, to know how policy makers can intervene. Smoking is a substantial risk factor for treatment non compliance, hence there is dire need to address this risk factor because treatment default not only hampers cure but can also lead to drug resistant TB or MDR-TB, a condition that is much more expensive and difficult to treat.

The association between tobacco consumption and TB has a long history. In the United States in the early 1900s, individuals who chewed tobacco were encouraged to switch to smoking. It was believed that spitting chewing tobacco resulted in transmission of M. tuberculosis, and that smoking cigarettes would improve public health. Ironically, this totally wrong message may have inadvertently encouraged risky smoking behavior. Early researches conducted in England showed an association between smoking and TB and they argued that the association was due to an increased risk of having latent TB progress to active disease in smokers compared to nonsmokers.

According to the World Health Organization (WHO) the risk of developing TB is estimated to be between 26 and 31 times greater in people living with HIV than among those without HIV infection. In 2013 there were 9 million new cases of TB, of which 1.1 million were people living with HIV.

China which loses 1 million people each year to smoking-related diseases, increased the consumption tax on cigarettes to 11% recently, a move that is a step in the right direction to discourage people from smoking, leading to a nicotine free society.

Half of long term smokers die prematurely due to smoking and half of these deaths occur in the middle aged. Causing a quarter of all avoidable deaths, TB is the largest cause of death from an infectious disease worldwide (after HIV), and is among the top 10 causes of illness, death and disability in terms of healthy life lost overall, notes Dr. K. M. Hassmiller, an expert in pulmonary TB.

Clarity Sibanda, Citizen News Service - CNS
September 15, 2015

No comments:

Post a Comment