Comparasion of Clinical Bacteriological Radiological Profile and Treatment Outcome of Smokers and Non Smokers Suffering from Pulmonary Tuberculosis

Abstract

Background: Smoking is a major risk factor for pulmonary tuberculosis (TB), influencing disease severity, bacteriological burden, and treatment outcomes. This study compares the clinical, bacteriological, radiological profile, and treatment outcomes between smokers and non-smokers with TB.Methods :A hospital-based prospective study was conducted from September 2007 to March 2012, including 64 sputum-positive TB patients registered under RNTCP. Patients were categorized into smokers and non-smokers, and their sputum AFB grading, radiological severity, and treatment outcomes were analyzed. Results: Smokers (65%) had more severe disease than non-smokers (35%).Higher bacillary loads (3+) were more frequent in heavy smokers (>300 smoking index, 44.4%).Smokers had significantly more advanced radiological findings (p<0.0001), with higher rates of cavitary lesions (75%).Sputum conversion was lower in smokers (90%) compared to non-smokers (100%) (p=0.0008).Treatment success was lower in smokers (89.7%) vs. non-smokers (95.2%), decreasing with increasing smoking index.Lost to follow-up was higher in smokers (10.2%) vs. non-smokers (4.7%), highest in smoking index >300 (22.2%). Conclusion: Smoking is associated with worse clinical and radiological presentation, higher bacillary loads, delayed sputum conversion, and lower treatment success in TB patients. These findings highlight the need for integrating smoking cessation into TB management to improve outcomes.