Summary: | Introduction
Smoking cessation should be part of tuberculosis (TB) treatment, but
a cessation service is not available as part of a routine TB service in most low- and
middle-income countries. WHO and The International Union Against Tuberculosis
and Lung Disease (The Union) issued a guideline and China implemented a pilot
project 5 years ago. This study aimed to determine changes in smoking status
among TB patients at 5 years after completion of anti-TB treatment to observe
long-term outcome of a smoking cessation project whose baseline characteristics
were associated with a relapse of smoking behavior.
Methods
A prospective longitudinal study was conducted 5 years after completion
of anti-TB treatment to assess changes in patient smoking status against individual
baseline data that were entered into a database at the time of TB registration.
The patients were tracked by trained village doctors and validated by township
health staff. Their smoking status was assessed and entered into the database
and analysed.
Results
Of the 800 TB patients registered at baseline, 650 (81.2%) were tracked.
Ninety-one (11.4%) patients died and 59 (7.4%) were lost to follow-up. The rates
of remaining non-smoking after 5 years were 82.0%, 63.0%, 49.6%, 43.5% and
30.0%, respectively for non-smokers, ex-smokers, current smokers who received
cessation intervention, recent quitters, and current smokers not on a cessation
intervention. The odds of smoking relapse were significantly higher for those aged
≥65 years (p=0.003) and registered in Xingguo County (p=0.025).
Conclusions
Findings from this study confirmed that non-smokers, ex-smokers and
current smokers who received cessation intervention at baseline maintained higher
non-smoking rates compared with those who did not receive the intervention. To
prevent relapse, intensive cessation support should be given to TB patients aged
≥65 years. TB programme managers need to ensure integration and provision of
smoking cessation advice and smoke-free policy in routine TB services.
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