Introduction:
Tuberculosis (TB) may recur even after successful treatment. The average reported incidence rates of recurrent TB (per 100 000 person-years) worldwide. Recurrent TB is a challenging issue to public health systems of Bangladesh. Previous study reported that smoking tobacco is a risk factor for getting recurrent TB. Sustainable, safe and clean smoke-free environments are necessary to control many diseases including TB. Occupational and environmental harms of tobacco cultivation, production, and consumption are highly associated for getting diseases like TB.

Objectives:
We conducted a qualitative study to investigate whether tobacco smoking increases the risk of tuberculosis (TB) recurrence.

Methods:
We randomly selected recurrent TB patients who had satisfactorily completed treatment for a previous TB episode. We conducted our study with 12 health practitioners and 12 follow-up interviews. The study was conducted from August to October 2018 in Bangladesh. An in-depth interview was conducted among the participants after taking informed consent.

Results:
Several factors influenced adherence of recurrent TB such as quality knowledge, engagement with appropriate treatment, perceptions of health, self-treatment, quality information, knowledge, and belief. Patients experienced many challenges during and after the treatment and they do not know how to lead their life safer and prevent recurrent infection through health promotion. There is a lack of appropriate health education and promotion to prevent recurrent TB. Our study assessed that the patients had double chance of recurrent TB who smoked more than 10 cigarettes a day.

Conclusion(s):
Our study suggests that smoking cigarette is associated with recurrent TB. We recommend appropriate TB treatment with cessation support center in every clinic to prevent recurrent TB.