RESEARCH PAPER
Cigarette smoking and tuberculosis in Cambodia: findings from a national sample
Pramil N Singh 1, 2, 3  
,  
Daravuth Yel 4
,  
They Kheam 5
,  
 
 
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1
Center for Health Research, School of Public Health, Loma Linda University, Phnom Penh, Cambodia
2
Department of Epidemiology, Biostatistics, and Population Medicine, School of Public Health, Loma Linda University, Loma Linda, USA
3
Department of Global Health, School of Public Health, Loma Linda University, Loma Linda, USA
4
World Health Organization/Tobacco Free Initiative, Phnom Penh, Cambodia
5
National Institute of Statistics, Ministry of Planning, Phnom Penh, Cambodia
CORRESPONDING AUTHOR
Pramil N Singh   

Center for Health Research, School of Public Health, Loma Linda University, Phnom Penh, Cambodia
Publication date: 2013-03-27
 
Tobacco Induced Diseases 2013;11(March):8
KEYWORDS
ABSTRACT
Background:
Cambodia has very high rates of tuberculosis and smoked tobacco use among adults. Efforts to control both tobacco use and tuberculosis in Cambodia need to be informed by nationally representative data. Our objective is to examine the relation between daily cigarette smoking and lifetime tuberculosis (TB) history in a national sample of adults in Cambodia.

Methods:
In 2011, a multi-stage, cluster sample of 15,615 adults (ages 15 years and older) from all regions of Cambodia were administered the Global Adult Tobacco Survey by interviewers from the National Institute of Statistics of Cambodia.

Results:
Our findings include: 1) among daily smokers, a significant positive relation between TB and number of cigarettes smoked per day (OR = 1.70 [95% CI 1.01, 2.87]) and pack-years of smoking (OR = 1.53 [95% CI 1.05, 2.25]) 2) a non-significant 58% increase in odds of ever having being diagnosed with TB among men who smoked manufactured cigarettes (OR = 1.58 [95% CI 0.97, 2.58]).

Conclusions:
In Cambodia, manufactured cigarette smoking was associated with lifetime TB infection and the association was most evident among the heaviest smokers (> 1 pack per day, > 30 pack years).

 
REFERENCES (35)
1.
World Health Organization: Factsheet No 104: Tuberculosis. Retrieved February 2013 from http://www.who.int/mediacentre....
 
2.
Basu S, Stuckler D, Bitton A, Glantz SA: Projected effects of tobacco smoking on worldwide tuberculosis control: mathematical modelling analysis. BMJ. 2011, 343: d5506-10.1136/bmj.d5506.
 
3.
A WHO/The Union Monograph on TB and Tobacco Control: Joining efforts to control two related global epidemics. 200, Geneva: World Health Organization.
 
4.
Lin HH, Ezzati M, Chang HY, Murray M: Association between tobacco smoking and active tuberculosis in Taiwan: prospective cohort study. Am J Respir Crit Care Med. 2009, 180: 5.
 
5.
Bates M, Pai M, Chang L, Lessa F, Smith K: Risk of tuberculosis from exposure to tobacco smoke. JAMA. 2007, 167: 4.
 
6.
Slama K, Chiang CY, Enarson DA, Hassmiller K, Fanning A, Gupta P, Ray C: Tobacco and tuberculosis: a qualitative systematic review and meta-analysis. Int J Tuberc Lung Dis. 2007, 11: 10.
 
7.
Lin HH, Ezzati M, Murray M: Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLoS Med. 2007, 4: 1-10.1371/journal.pmed.0040001.
 
8.
Jha P, Jacob B, Gajalakshmi V, Gupta PC, Dhingra N, Kumar R, Sinha DN, Dikshit RP, Parida DK, Kamadod R, Boreham J, Peto R: A nationally representative case–control study of smoking and death in India. N Engl J Med. 2008, 358: 11.
 
9.
Jee SH, Golub JE, Jo J, Park IS, Ohrr H, Samet JM: Smoking and risk of tuberculosis incidence, mortality, and recurrence in South Korean men and women. Am J Epidemiol. 2009, 170: 12-10.1093/aje/kwp115.
 
10.
Singh PN, Yel D, Sin S, Khieng S, Lopez J, Job J: Tobacco use among adults in Cambodia: evidence for a tobacco epidemic among women. Bull World Health Org . 2009, 87: 12-10.2471/BLT.07.050666.
 
11.
Kheam T, Yel D, Singh PN: 2011 National Adult Tobacco Survey of Cambodia (NATSC, 2011) Monograph. 2011, National Institute of Statistics (Ministry of Planning, Cambodia): WHO Western Pacific Region Periodical.
 
12.
Singh P, Yel D, Sovann S, Job J, Rudatsikira E, Petersen F, Ferry L, Knutsen S: Design, validation, and administration of a nationwide survey of adult tobacco use in Cambodia [abstract]. Building capacity for a tobacco-free world. Washington, DC: Paper presented at the 13th World Conference on Tobacco or Health, Retrieved from http://2006.confex.com/uicc/wc....
 
13.
Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Cigarette Package Warning Labels and Interest in Quitting Smoking: The global adult tobacco survey in 14 countries, 2008–2010. MMWR. 2011, 60: 20.
 
14.
Flaherty JA, Gaviria FM, Pathak D, Mitchell T, Wintrob R, Richman JA: Developing instruments for cross-cultural psychiatric research. J Nerv Ment Dis. 2013, 176: 5.
 
15.
Greenland S: Dose–response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology. 1995, 6: 4-10.1097/00001648-199501000-00002.
 
16.
Awaisu A, Nik Mohamed MH, Abd Aziz N, Syed Sulaiman SA, Mohamad Noordin N, Muttalif AR: Tobacco use prevalence, knowledge, and attitudes among newly diagnosed tuberculosis patients in Penang State and Wilayah Persekutuan Kuala Lumpur, Malaysia. Tob Induc Dis. 2010, 8: 1-10.1186/1617-9625-8-1.
 
17.
Sandra Hodge GH, Ahern J, Hubertus J, Holmes M, Reynolds PN: Smoking alters alveolar macrophage recognition and phagocytic AbilityImplications in chronic obstructive pulmonary disease. Am J Respir Cell Mol Biol. 2007, 37: 6.
 
18.
Bagaitkar J, Demuth DR, Scott DA: Tobacco use increases susceptibility to bacterial infection. Tob Induc Dis. 2008, 4: 12-10.1186/1617-9625-4-12.
 
19.
Saldias F, Orlando D: Cigarette Smoking and Lower Respiratory Tract Infection. Bronchitis. Bronchitis. Edited by: Ignacio MÃ-L. 2011, Rijeka, Croatia: Intech,http://www.intechopen.com/book....
 
20.
Marcy TW, Merrill WW: Cigarette smoking and respiratory tract infection. Clin Chest Med. 1987, 8: 3.
 
21.
Morrow JD, Frei B, Longmire AW, Gaziano JM, Lynch SM, Shyr Y: Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers — smoking as a cause of oxidative damage. NEJM. 1995, 332: 18.
 
22.
Arcavi L, Benowitz NL: Cigarette smoking and infection. Arch Intern Med. 2004, 164: 20.
 
23.
Brown GP, Iwamoto GK, Monick MM, Hunninghake GW: Cigarette-smoking decreases interleukin-1 release by human alveolar macrophages. Am J Physiol. 1989, 256: 2.
 
24.
Lienhardt KF C, Sillah JS, Bah B, Gustafson P, Warndorff D, Palayew M, Lisse I, Donkor S, Diallo S, Manneh K, Adegbola R, Aaby P, Bah-Sow O, Bennett S, McAdam K: Investigation of the risk factors for tuberculosis: a case–control study in three countries in West Africa. Int J Epidemiol. 2005, 34: 4.
 
25.
Szilasi M, Dolinay T, Nemes Z, Strausz J: Pathology of chronic obstructive pulmonary disease. Pathol Oncol Res. 2006, 12: 1.
 
26.
Kubo K, Yamazaki Y, Hachiya T, Hayasaka M, Honda T, Hasegawa M: Mycobacterium avium-intracellulare & pulmonary infection in patients without known predisposing lung disease. Lung. 1998, 176: 6.
 
27.
Shaler CR, Horvath CN, McCormick S, Jeyanathan M, Khera A, Zganiacz A, Kasinska J, Stampfli MR, Xing Z: Continuous and discontinuous cigarette smoke exposure differentially affects protective Th1 immunity against pulmonary tuberculosis. PLoS One. 2013, 8: 1.
 
28.
McComb JG RM, Liu XH, Pilewski JM, Ray P, Watkins SC, Choi AM, Lee JS: CX3CL1 upregulation is associated with recruitment of CX3CR1+ mononuclear phagocytes and T lymphocytes in the lungs during cigarette smoke-induced emphysema. Am J Pathol. 2008, 173: 4.
 
29.
Rudatsikira E, Muula AS: Prevalence and predictors of environmental tobacco smoke exposure among adolescents in cambodia. Indian J Community Med. 2009, 35: 1.
 
30.
Rudatsikira E, Knutsen SF, Job JS, Singh PN, Yel D, Montgomery SB: Exposure to environmental tobacco smoke in the nonsmoking population of Cambodia. Am J Prev Med. 2008, 34: 1-10.1016/j.amepre.2007.09.017.
 
31.
Idolor LF, DEG TS, Francisco NA, Roa CC, Ayuyao FG, Tady CZ: Burden of obstructive lung disease in a rural setting in the Philippines. Respirology. 2011, 16: 7.
 
32.
Smith KR, Samet JM, Romieu I, Bruce N: Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax. 2000, 55: 6.
 
33.
Lopez JR, Somsamouth K, Mounivong B, Sinclair R, Singh PN: Carbon monoxide levels in waterpipe smokers in rural Laos PDR. Tob Control. 2012, 21: 5.
 
34.
Singh PN, Natto Z, Yel D, Job J, Knutsen S: Betel quid use in relation to infectious disease outcomes in Cambodia. Int J Infect Dis. 2012, 16: 4.
 
35.
American Thoracic Society and Center for Disease Control: Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med. 2000, 161: 4.
 
 
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