Smoking by tuberculosis patients in Kerala, India: proactive cessation efforts are urgently needed
Kavumpurathu Raman Thankappan, Professor, Achutha Menon Centre, Sree Chitra Tirunal Institute for Medical Sciences, Trivandrum, India

Abstract

Background:
The objectives of this study were to document smoking patterns among former Tuberculosis (TB) patients at eight different points of time before, during and after treatment, and to investigate the frequency and content of quit smoking messages received
by them.

Methods:
A stratified random sample of 215 male TB patients who had completed directly observed treatment, short course (DOTS) in the last six to nine months was surveyed from two districts of Kerala using a pre-tested semi structured interview schedule.

Results:
Six months prior to diagnosis of TB, 94.4% male TB patients were ever smokers and 71.2% were current smokers. Although 87% of patients quit smoking soon after diagnosis, 36% relapsed by six months post treatment. Content analysis of quit messages showed that less than half of all messages were TB specific, the rest being very general short instructions to quit smoking. Smoking more than 15 sticks at the time of diagnosis was significantly associated with fewer quit rate during treatment (Odds Ratio 8.0, CI: 2.1 30.9)

Conclusion:
Messages not to smoke often go unheeded because they tend to be very general and do not specifically tie smoking to TB incidence or relapse.