PARIS 2008: Up to 1-in-5 TB deaths attributed to tobacco use

Photo by buoybarrelWith 50% of all deaths from lung disease linked to tobacco use, control of the substance is high on the agenda of the 39th World Conference on Lung Health in Paris, France.

“Up to one in five TB (tuberculosis) deaths could be avoided if TB patients were not smokers,” Dr Nils Billo, Executive Director of the International Union Against Tuberculosis and Lung Disease (IUATLD), said during the conference.

Smoking is also associated with recurrent TB and people with the disease who smoke have a higher risk of mortality than non-smokers with TB. The scaling-up of tobacco cessation services for people with TB is therefore a clear priority.

Dr Mario Raviglione, Director of the Stop TB Department under WHO discussed the Practical Approach to Lung health (PAL) with delegates at the conference. The approach focuses on comprehensive treatment for all respiratory conditions and diseases, not just TB.

About 80% of smokers live in low and middle-income countries and 520 million people will die from tobacco-related illnesses in the next 50 years, according to available data. By 2030 the annual number of deaths from tobacco will increase from five million to more than eight million.

The IUATLD has helped raise awareness of tobacco hazards, encouraging its partners to play an active role in tobacco control and recognize the link between tobacco and TB.

It has also promoted effective tobacco control policies through technical resources, training a new generation of managers and practitioners and supporting effective programs through grants.

WHO and the union published a joint monograph on TB and tobacco control in 2007 and key elements of the policy include the identification and offers of counselling for smokers assessed for TB or other respiratory diseases.

The monograph also called for the operation of smoke-free public health centres and the training of health workers to deliver smoking cessation treatment.

Concerns over the high rates of tobacco use among doctors and healthcare providers in high TB-burdened countries were also raised during discussions at the conference. In some regions more than 50% of healthcare workers use the drug, making it difficult for them to play a genuine role in tobacco cessation programs.

Bobby Ramakant-CNS