Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Tuberculosis and Tobacco smoking in Malaysia

Tee Guat Hiong*, Mohd Hatta Abdul Mutalip**, Jiloris F Dony***, Sobashini Kanniah****, Norzawati Yeop*, Faezah Paiwai*, Mohd Hazrin Hasim*, Ahmad Nadzri Jai*, Sayan Pan*, Jamsee Ongi*

*Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, **Lembah Pantai Health District Office, Ministry of Health Malaysia, ***TB/Leprosy Sector, Disease Control Division, Ministry of Health Malaysia, ****Seberang Prai Tengah Health Office, Penang


Introduction: Tobacco smoking has been shown to be an important risk factor in the development of tuberculosis (TB).  This study aimed to examine the factors associated between TB infection and tobacco smoking. 

Methodology: Data were obtained from National Tuberculosis Information System (TBIS) collected in the year 2012. All confirmed cases diagnosed for TB were analysed.  Descriptive and logistic regression analyses were performed by using SPSS version 19.

Results: A total of 21,224 TB cases were reported in 2012. More than a third (34.6%) of TB patients smoked. TB patients who smoked were significantly higher among males (50.8%), 40-49 years old (43.2%), Malays (38.1%), Malaysians (35.2%), those with pulmonary TB (35.8%), re-treated cases (41.5%) and among defaulters (56.3%). The estimated odds of smoking among TB patients was higher among males (adjusted Odds Ratio (aOR) 23.38, 95% CI: 20.50, 26.67) and patients with pulmonary TB (aOR 1.29, 95% CI: 1.13, 1.47). Age was a significant predictor for smoking among TB patients where it was found to be higher especially among those aged 30 to 49 years old. Ethnicity was not a significant predictor for smoking among TB patients. On treatment outcomes; those who defaulted treatment had higher odds for smoking (aOR 3.73, 95% CI: 1.69, 8.22), followed by patients who died (aOR 2.40, 95% CI: 1.10, 5.23) and slightly lower for those who were cured (aOR 2.22, 95% CI: 1.02, 4.81).

Conclusion: The prevalence of tobacco smoking among TB patients was high. Tuberculosis has been shown to be related to tobacco smoking and has negative effect on the treatment outcome of tuberculosis. Thus, TB patients need to be educated on the dangers of tobacco smoking and given advice to quit smoking in order to improve the treatment outcome.