Millions Of TB Deaths Could Be Avoided By Curbing Smoking

Curbing smoking worldwide through aggressive tobacco control could prevent millions of deaths from tuberculosis (TB), according to new research published in the BMJ that says smoking is undermining the progress towards the millenium goals for reducing TB deaths.

Physician Dr Sanjay Basu, from the Department of Medicine at the University of California San Francisco (UCSF), and colleagues, developed a mathematical model of TB epidemics to calculate the effect of future smoking trends on TB control. They took into account factors like changing trends in smoking, TB case detection and treatment success, and HIV prevalence.

The model predicts that if smoking is not curbed worldwide (that is it continues to follow current trends), it could lead to 18 million new cases of TB and 40 million deaths from the disease between 2010 and 2050.

Compared with models that do not take the effect of smoking into account, the effect of smoking increases the number of TB cases from 256 to 274 million (7%), and deaths from 101 to 61 to 101 million (66%), write the authors.

Smoking is expected to delay the millenium development goal target, which aims to cut TB deaths by 50% between 1990 and 2015, they add.

Basu and colleagues write that nearly one five people in the world smoke. The countries likely to be most affected by new smoking-linked TB are in Africa, Southeast Asia and the Eastern Mediterranean.

Using the model to then predict what effect aggressive tobacco control might have, the researchers find it would prevent 27 million smoking-related deaths from TB by 2050. The formula they used for aggressive tobacco control assumed a reduction in smoking rates of 1% a year until eradication.

Conversely, should smoking rates rise to 50% of adults (about the same rate as countries with high tobacco use), the model predicts 34 million more people would die from smoking-related TB by 2050.

The researchers conclude that:

“Tobacco smoking could substantially increase tuberculosis cases and deaths worldwide in coming years, undermining progress towards tuberculosis mortality targets. Aggressive tobacco control could avert millions of deaths from tuberculosis.”

Written by Catharine Paddock