Background:
Drug resistant tuberculosis (DR-TB) remains a significant cause of morbidity and mortality in South Africa. High smoking prevalence and the risk of adverse TB outcomes has been reported among TB patients in South Africa. This study investigated smoking-related prevalence and related behaviors of drug resistant tuberculosis (DR-TB) inpatients in KwaZulu-Natal (KZN), South Africa.

Methods:
This study was conducted in three hospitals in KZN between September and December 2016. Eligible participants, who had DR-TB and self-reported as smokers were asked to complete a questionnaire which was administered by trained interviewers. The questionnaire, which was adapted from the global adult tobacco survey, included questions about smoking behaviour, types of cigarettes smoked and attempts at cessation. The questionnaire has been previously shown to be reliable. The study data were analysed using SPSS.

Results:
The questionnaire was voluntarily completed by 211 DR-TB inpatients who self identified as smokers. Overall, 201 respondents (95.3%) stated that they had ever smoked cigarettes, 104 (49.3%) currently smoke cigarettes on a daily basis, 27(12.8%) on less than daily basis, 51(24.2%) do not currently smoke cigarettes at all. Smoking prevalence was significantly higher among males (88.6%) than among females (11.4%). The study revealed that 179 (84.8%) respondents currently smoke manufactured cigarettes, 20 (9.5%) reported that they also use smokeless tobacco, and 168 (79.6%) had unsuccessfully tried to stop smoking during the past 12 months.

Conclusions:
This study shows a high prevalence of smoking among DR-TB male inpatients in KZN. While most patients reported having made attempts to quit smoking, they have not been successful in their attempts. This study demonstrates that a range of actions to reduce smoking among patients with TB should be considered including restrictions on access and support for smoking cessation.