World TB Day: Tobacco smokers at higher risk of developing tuberculosis, say experts

New Delhi: Tobacco smokers are at a higher risk of developing tuberculosis and experiencing more severe forms of the disease, experts said on Saturday.

Additionally, exposure to second-hand smoke can worsen tuberculosis (TB) outcomes and hinder treatment effectiveness, the experts said as they emphasised the urgent need for strengthening tobacco control laws to combat this dual threat.

World Tuberculosis Day is observed on March 24. The date marks the day in 1882 when Dr Robert Koch announced that he had discovered the bacterium that causes TB, paving the way for diagnosing and curing this disease.

According to the World Health Organization’s (WHO) Global TB Report 2023, India accounted for the highest number of tuberculosis cases in the world in 2022, representing a staggering 27 per cent of the global burden, India recorded 2.8 million (28.2 lakh) TB cases in 2022.

Prime Minister Narendra Modi’s ambitious vision to eliminate TB by 2025 demonstrates the government’s commitment to addressing this issue comprehensively, the experts said.

One significant factor exacerbating the TB burden in India is the connection between tuberculosis and tobacco use, they said.

According to the Global Adult Tobacco Survey in India, a staggering number of individuals are tobacco users.

“To combat this dual threat of TB, there is an urgent need to strengthen tobacco control laws. By implementing stringent tobacco control measures, India can mitigate the impact of tobacco use on TB incidence and mortality rates,” Bhavna Mukhopadhyay, Chief Executive, Voluntary Health Association of India said.

“Moreover, there is a pressing need to enhance tobacco cessation services to support individuals in quitting tobacco use and reducing their risk of TB and other related health complications,” she added.

Tuberculosis, primarily caused by mycobacterium tuberculosis, poses a complex challenge in India, where roughly a quarter of the population is infected and at risk of developing the disease.

Recent research has shed light on a correlation between tobacco consumption and TB, illustrating how smoking significantly increases the risk of contracting, developing, and dying of TB.

“Studies indicate that individuals who smoke tobacco are 2.5 times more likely to develop pulmonary tuberculosis compared to non-smokers. TB patients who smoke face double the risk of death during treatment as smoking not only heightens susceptibility to TB but also undermines treatment effectiveness,” said Dr Sonu Goel, Professor, Department of Community Medicine and School of Public Health PGIMER.

“It also increases the likelihood of relapse and adds to the burden faced by patients and healthcare systems alike,” Goel said.

Additionally, the widespread prevalence of tobacco use, with an estimated 10 per cent of India’s populace being tobacco users, further complicates efforts to combat TB in India, Goel said.

“By quitting smoking, individuals can protect themselves and their communities from the devastating impact of TB,” Goel added.

Despite commendable initiatives by the central government, such as the Cigarettes and Other Tobacco Products Act (COTPA) and the National Tobacco Control Programme (NTCP), stronger enforcement and evidence-based interventions are imperative to effectively curb tobacco consumption, experts stressed.

Moreover, there is a growing consensus on the importance of collaboration between health sectors to efficiently address the tobacco-TB connection, utilising existing TB infrastructure to deliver cessation interventions effectively, they said.

The intertwined relationship between tobacco smoking and tuberculosis presents a formidable challenge to public health in India, they said.
Coordinated efforts, encompassing both preventive and treatment strategies, are essential to combat tobacco use and mitigate its adverse impact on TB incidence, progression, and mortality, the experts said.