Published ahead of print on July 28, 2004, doi:10.1164/rccm.200404-512OC
Am. J. Respir. Crit. Care Med., Volume 170, Number 9, November 2004, 1027-1033
A more recent version of this article appeared on November 1, 2004
Submitted on May 11, 2004
Accepted on July 27, 2004
Smoking and Tuberculosis among the Elderly in Hong Kong
Chi C Leung1*, Teresa Li2, Tai H Lam3, Wing W Yew4, Wing S Law1, Cheuk M Tam1, Wai M Chan2, Chi K Chan1, Kin S Ho2, and Kwok C Chang1
1 ServiceDepartment of Health, TB and Chest Service, Hong Kong, China,
2 Department of Health, Elderly Health Service, Hong Kong, China,
3 Department of Community Medicine, The University of Hong Kong, Hong Kong, China,
4 TB and Chest Unit, Grantham Hospital, Hong Kong, China
* To whom correspondence should be addressed. E-mail: cc_leung{at}dh.gov.hk.
A cohort of 42,655 clients first registered with the Elderly Health Service in 2000 were followed prospectively through the tuberculosis notification registry until the end of 2002. A total of 286 active tuberculosis cases (186 culture-confirmed) were identified. The annual tuberculosis notification rates were 735, 427, and 174 per 100,000 among current smokers, ex-smokers and never-smokers respectively (P<0.001). The trend in tuberculosis risk persisted after control of background characteristics using Cox proportional hazards analysis (adjusted hazard ratios: 2.63:1.41:1, p<0.001). In comparison with never-smokers, current smokers had excess risk of pulmonary tuberculosis (adjusted hazard ratio: 2.87, 95%CI: 2.00-4.11, P<0.001), but not extrapulmonary tuberculosis (adjusted hazard ratio: 1.04, 95%CI: 0.33-3.30, P=0.95). Among the current smokers, those who developed tuberculosis smoked more cigarettes per day than those who did not (13.43, SD 8.76 versus 10.96, SD 7.87, P= 0.01). A statistically significant dose-response relationship was observed with respect to active tuberculosis and culture-confirmed tuberculosis (both P <0.05). Smoking accounted for 32.8% (95% CI: 14.9 - 48.0%), 8.6% (95% CI: 3.3 - 15.1%) and 18.7% (95% CI: 7.7 - 30.4%) of the tuberculosis risk among males, females and the whole cohort respectively. About 44.9% (95%CI: 20.7-64.6%) of the gender difference was attributable to smoking.
Key words: smoking, tuberculosis, Chinese, elderly, notification
This article has been cited by other articles:
|
|
|
|
 
S. H. Jee, J. E. Golub, J. Jo, I. S. Park, H. Ohrr, and J. M. Samet
Smoking and Risk of Tuberculosis Incidence, Mortality, and Recurrence in South Korean Men and Women
Am. J. Epidemiol.,
November 16, 2009;
(2009)
kwp308v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H.-H. Lin, M. Ezzati, H.-Y. Chang, and M. Murray
Association between Tobacco Smoking and Active Tuberculosis in Taiwan: Prospective Cohort Study
Am. J. Respir. Crit. Care Med.,
September 1, 2009;
180(5):
475 - 480.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Rastegar
Tuberculosis and Substance Abuse
Arch Intern Med,
July 13, 2009;
169(13):
1245 - 1245.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. C. Leung, T. H. Lam, W. M. Chan, W. W. Yew, K. S. Ho, G. M. Leung, W. S. Law, C. M. Tam, C. K. Chan, and K. C. Chang
Diabetic Control and Risk of Tuberculosis: A Cohort Study
Am. J. Epidemiol.,
June 15, 2008;
167(12):
1486 - 1494.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P Wu, B J Cowling, C M Schooling, I O L Wong, J M Johnston, C-C Leung, C-M Tam, and G M Leung
Age-period-cohort analysis of tuberculosis notifications in Hong Kong from 1961 to 2005
Thorax,
April 1, 2008;
63(4):
312 - 316.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Forssbohm, M. Zwahlen, R. Loddenkemper, and H. L. Rieder
Demographic characteristics of patients with extrapulmonary tuberculosis in Germany
Eur. Respir. J.,
January 1, 2008;
31(1):
99 - 105.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. C. Leung, T. H. Lam, and W. W. Yew
Smoking and Tuberculosis: Infection, Disease, and Mortality
Arch Intern Med,
October 8, 2007;
167(18):
2008 - 2009.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. C. Leung, T. H. Lam, W. M. Chan, W. W. Yew, K. S. Ho, G. Leung, W. S. Law, C. M. Tam, C. K. Chan, and K. C. Chang
Lower Risk of Tuberculosis in Obesity
Arch Intern Med,
June 25, 2007;
167(12):
1297 - 1304.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. C. Leung, W. W. Yew, W. S. Law, C. M. Tam, M. Leung, Y. W. Chung, K. W. Cheung, K. W. Chan, and F. Fu
Smoking and tuberculosis among silicotic patients
Eur. Respir. J.,
April 1, 2007;
29(4):
745 - 750.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. N. Bates, A. Khalakdina, M. Pai, L. Chang, F. Lessa, and K. R. Smith
Risk of Tuberculosis From Exposure to Tobacco Smoke: A Systematic Review and Meta-analysis
Arch Intern Med,
February 26, 2007;
167(4):
335 - 342.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. G Coen, J. Tully, J. M Stuart, D. Ashby, R. M Viner, and R. Booy
Is it exposure to cigarette smoke or to smokers which increases the risk of meningococcal disease in teenagers?
Int. J. Epidemiol.,
April 1, 2006;
35(2):
330 - 336.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. C Gupta, M. S Pednekar, D. Parkin, and R Sankaranarayanan
Tobacco associated mortality in Mumbai (Bombay) India. Results of the Bombay Cohort Study
Int. J. Epidemiol.,
December 1, 2005;
34(6):
1395 - 1402.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. W. Yew and C. C. Leung
Are Some People Not Safer after Successful Treatment of Tuberculosis?
Am. J. Respir. Crit. Care Med.,
June 15, 2005;
171(12):
1324 - 1325.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Nemery, W. W. Yew, R. Albert, C. Brun-Buisson, W. MacNee, F. J. Martinez, D. C. Angus, and E. Abraham
Tuberculosis, Nontuberculous Lung Infection, Pleural Disorders, Pulmonary Function, Respiratory Muscles, Occupational Lung Disease, Pulmonary Infections, and Social Issues in AJRCCM in 2004
Am. J. Respir. Crit. Care Med.,
March 15, 2005;
171(6):
554 - 562.
[Full Text]
[PDF]
|
|
|
Copyright © 2004 American Thoracic Society
|
|
|
