Correlation between Smoking and the Risk of Death in Patients with Lung Tuberculosis: A Meta-Analysis

Hakim Anasufalah

Masters Program in Public Health, Universitas Sebelas Maret


Background: Previous studies estimated that 20% of Tuberculosis cases in adults are attributable to smoking, compared with 16% for human immunodeficiency virus and 15% for diabetes. Compared with nonsmokers, those who smoke tobacco have twice the risk of Tuberculosis disease, and patients with Tuberculosis who smoke have twice the risk of death during Tuberculosis treatment. This study aimed to explore correlation between smoking and the risk of death in patients with lung Tuberculosis using meta-analysis.

Subjects and Method: A systematic review and meta analysis was conducted by collecting articles from PubMed, ScienceDirect, and Google Scholar databases. The determination of selected articles based on eligible criteria using PICO: (1) Population= patients with lung Tuberculosis, (2) Intervention= smoking, (3) Comparison= non smoking, and (4) Out­come= death. Keywords used “Smoking” OR “ Smokers” AND “ Mortaliy” AND “ Pulmonary Tuberculosis” AND “ Adjusted odds Ratio”. The inclusion articles were full text, observational studies, published from year 2010 to 2021, and reported odds ratio. The articles were collected by PRISMA flow diagram. Selected articles were assessed using Review Manager 5.3.

Results: A meta-analysis involved six cohort studies from Malaysia, South Korea, Iran, Mozambique, Pakistan, and Taiwan. This study showed that smoking increased the risk of death in patients with lung Tuberculosis (aOR= 2.96; 95% CI= 2.85 to 3.08; p <0.001). I2= 42% showed that there were homogenous characteristics between studies, so fixed-effect model selected for analysis in meta-analysis.

Conclusion: Smoking increases the risk of death in patients with lung Tuberculosis.

Keywords: smoking, lung Tuberculosis, COVID-19, death Kematian

Correspondence:  Hakim Anasulfalah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: Mobile: 085602655400


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