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Exposure to Secondhand Smoke and Risk of Tuberculosis: Prospective Cohort Study

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  • Hsien-Ho Lin
  • Yi-Ting Chiang
  • Jen-Hsiang Chuang
  • Shiang-Lin Yang
  • Hsing-Yi Chang
  • Majid Ezzati
  • Megan Murray

Abstract

Background: Prospective evidence on the association between secondhand-smoke exposure and tuberculosis is limited. Methods: We included 23,827 never smokers from two rounds (2001 and 2005) of Taiwan National Health Interview Survey. Information on exposure to secondhand smoke at home as well as other sociodemographic and behavioral factors was collected through in-person interview. The participants were prospectively followed for incidence of tuberculosis through cross-matching the survey database to the national tuberculosis registry of Taiwan. Results: A total of 85 cases of active tuberculosis were identified after a median follow-up of 7.0 years. The prevalence of exposure to secondhand smoke at home was 41.8% in the study population. In the multivariable Cox proportional hazards analysis, secondhand smoke was not associated with active tuberculosis (adjusted hazard ratio [HR], 1.03; 95% CI, 0.64 to 1.64). In the subgroup analysis, the association between secondhand smoke and tuberculosis decreased with increasing age; the adjusted HR for those = 18 and = 40 and = 60 years old was 8.48 (0.77 to 93.56), 2.29 (0.75 to 7.01), 1.33 (0.58 to 3.01), and 0.66 (0.35 to 1.23) respectively. Results from extensive sensitivity analyses suggested that potential misclassification of secondhand-smoke exposure would not substantially affect the observed associations. Conclusions: The results from this prospective cohort study did not support an overall association between secondhand smoke and tuberculosis. However, the finding that adolescents might be particularly susceptible to secondhand smoke's effect warrants further investigation.

Suggested Citation

  • Hsien-Ho Lin & Yi-Ting Chiang & Jen-Hsiang Chuang & Shiang-Lin Yang & Hsing-Yi Chang & Majid Ezzati & Megan Murray, 2013. "Exposure to Secondhand Smoke and Risk of Tuberculosis: Prospective Cohort Study," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-6, October.
    • Handle: RePEc:plo:pone00:0077333
    DOI: 10.1371/journal.pone.0077333
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    References listed on IDEAS

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    1. Lönnroth, Knut & Jaramillo, Ernesto & Williams, Brian G. & Dye, Christopher & Raviglione, Mario, 2009. "Drivers of tuberculosis epidemics: The role of risk factors and social determinants," Social Science & Medicine, Elsevier, vol. 68(12), pages 2240-2246, June.
    2. Hsien-Ho Lin & Majid Ezzati & Megan Murray, 2007. "Tobacco Smoke, Indoor Air Pollution and Tuberculosis: A Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 4(1), pages 1-1, January.
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