Objective: Although tuberculosis has already become uncommon in industrialised countries, is a major burden in many developing countries, including India. This paper examines the association between smoking (mainly bidi smoking) and tuberculosis in Mumbai, India.
Method: To study the possible association between smoking and tuberculosis, recruitment of a cohort of 81,443 men > or =35 years began in 1991 and was followed up to the end of 2003 in Mumbai.
Results: The adjusted risk of tuberculosis deaths among bidi smokers was 2.60 (95% confidence interval (CI): 2.02, 3.33) times higher than never-smokers, with a significant trend for daily frequency of bidi smoking. Also the risk of prevalence of self reported tuberculosis among bidi smokers was 5.23 (95% CI: 4.01, 6.82) times higher than never-smokers.
Conclusion: In India around 32% of tuberculosis deaths can be attributable to bidi smoking. Thus, bidi smoking seems to be an important cause of manifestation and death from tuberculosis.