Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.

<h4>Background</h4>Tobacco smoking, passive smoking, and indoor air pollution from biomass fuels have been implicated as risk factors for tuberculosis (TB) infection, disease, and death. Tobacco smoking and indoor air pollution are persistent or growing exposures in regions where TB pose...

Full description

Saved in:
Bibliographic Details
Main Authors: Hsien-Ho Lin, Majid Ezzati, Megan Murray
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2007-01-01
Series:PLoS Medicine
Online Access:https://doi.org/10.1371/journal.pmed.0040020
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849426028171100160
author Hsien-Ho Lin
Majid Ezzati
Megan Murray
author_facet Hsien-Ho Lin
Majid Ezzati
Megan Murray
author_sort Hsien-Ho Lin
collection DOAJ
description <h4>Background</h4>Tobacco smoking, passive smoking, and indoor air pollution from biomass fuels have been implicated as risk factors for tuberculosis (TB) infection, disease, and death. Tobacco smoking and indoor air pollution are persistent or growing exposures in regions where TB poses a major health risk. We undertook a systematic review and meta-analysis to quantitatively assess the association between these exposures and the risk of infection, disease, and death from TB.<h4>Methods and findings</h4>We conducted a systematic review and meta-analysis of observational studies reporting effect estimates and 95% confidence intervals on how tobacco smoking, passive smoke exposure, and indoor air pollution are associated with TB. We identified 33 papers on tobacco smoking and TB, five papers on passive smoking and TB, and five on indoor air pollution and TB. We found substantial evidence that tobacco smoking is positively associated with TB, regardless of the specific TB outcomes. Compared with people who do not smoke, smokers have an increased risk of having a positive tuberculin skin test, of having active TB, and of dying from TB. Although we also found evidence that passive smoking and indoor air pollution increased the risk of TB disease, these associations are less strongly supported by the available evidence.<h4>Conclusions</h4>There is consistent evidence that tobacco smoking is associated with an increased risk of TB. The finding that passive smoking and biomass fuel combustion also increase TB risk should be substantiated with larger studies in future. TB control programs might benefit from a focus on interventions aimed at reducing tobacco and indoor air pollution exposures, especially among those at high risk for exposure to TB.
format Article
id doaj-art-b9d4d76d39ad48debb7d2b584422d48f
institution Kabale University
issn 1549-1277
1549-1676
language English
publishDate 2007-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS Medicine
spelling doaj-art-b9d4d76d39ad48debb7d2b584422d48f2025-08-20T03:29:34ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762007-01-0141e2010.1371/journal.pmed.0040020Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.Hsien-Ho LinMajid EzzatiMegan Murray<h4>Background</h4>Tobacco smoking, passive smoking, and indoor air pollution from biomass fuels have been implicated as risk factors for tuberculosis (TB) infection, disease, and death. Tobacco smoking and indoor air pollution are persistent or growing exposures in regions where TB poses a major health risk. We undertook a systematic review and meta-analysis to quantitatively assess the association between these exposures and the risk of infection, disease, and death from TB.<h4>Methods and findings</h4>We conducted a systematic review and meta-analysis of observational studies reporting effect estimates and 95% confidence intervals on how tobacco smoking, passive smoke exposure, and indoor air pollution are associated with TB. We identified 33 papers on tobacco smoking and TB, five papers on passive smoking and TB, and five on indoor air pollution and TB. We found substantial evidence that tobacco smoking is positively associated with TB, regardless of the specific TB outcomes. Compared with people who do not smoke, smokers have an increased risk of having a positive tuberculin skin test, of having active TB, and of dying from TB. Although we also found evidence that passive smoking and indoor air pollution increased the risk of TB disease, these associations are less strongly supported by the available evidence.<h4>Conclusions</h4>There is consistent evidence that tobacco smoking is associated with an increased risk of TB. The finding that passive smoking and biomass fuel combustion also increase TB risk should be substantiated with larger studies in future. TB control programs might benefit from a focus on interventions aimed at reducing tobacco and indoor air pollution exposures, especially among those at high risk for exposure to TB.https://doi.org/10.1371/journal.pmed.0040020
spellingShingle Hsien-Ho Lin
Majid Ezzati
Megan Murray
Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.
PLoS Medicine
title Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.
title_full Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.
title_fullStr Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.
title_full_unstemmed Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.
title_short Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.
title_sort tobacco smoke indoor air pollution and tuberculosis a systematic review and meta analysis
url https://doi.org/10.1371/journal.pmed.0040020
work_keys_str_mv AT hsienholin tobaccosmokeindoorairpollutionandtuberculosisasystematicreviewandmetaanalysis
AT majidezzati tobaccosmokeindoorairpollutionandtuberculosisasystematicreviewandmetaanalysis
AT meganmurray tobaccosmokeindoorairpollutionandtuberculosisasystematicreviewandmetaanalysis