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. 2016 Jan 18;2016(1):CD011125.
doi: 10.1002/14651858.CD011125.pub2.

Smoking cessation interventions for pulmonary tuberculosis treatment outcomes

Kathiresan Jeyashree  1 , Soundappan Kathirvel, Hemant D Shewade, Harpreet Kaur, Sonu Goel
Affiliations

Smoking cessation interventions for pulmonary tuberculosis treatment outcomes

Kathiresan Jeyashree et al. Cochrane Database Syst Rev. .

Abstract

Background: Active smoking increases the risk of tuberculosis (TB) infection 2 to 2.5 times and is significantly associated with recurrent TB and TB mortality. Observational studies have shown associations between smoking and poor TB treatment outcomes such as increased loss to follow-up rate, severity of disease, drug resistance and slow smear conversion. Since most smoking-related immunologic abnormalities are reversible within six weeks of stopping smoking, smoking cessation may have substantial positive effects on TB treatment outcomes, TB relapse and future lung disease.

Objectives: To analyse the effect of tobacco smoking cessation interventions (SCIs) on the treatment outcomes of people with adult pulmonary TB.

Search methods: We searched the Cochrane Tobacco Addiction Group Specialised Register using free-text and MeSH terms for TB and antitubercular treatment. We also searched MEDLINE and EMBASE using the same topic-related terms, combined with the search terms used to identify trials of tobacco cessation interventions from the Specialised Register. We also searched reference list of articles and reviews, the Conference Paper Index, clinicaltrials.gov and grey literature. The searches are current to 29th July 2015.

Selection criteria: Individual and cluster-randomised controlled trials (RCTs), regardless of date, language and publication status, studies of adults with pulmonary TB on first-line anti-tubercular drugs, with interventions at either an individual or a population level, delivered separately or as part of a larger tobacco control package. This included any type of behavioural or pharmaceutical intervention or both for smoking cessation.

Data collection and analysis: Using the eligibility criteria, two authors independently checked the abstracts of retrieved studies for relevance, and acquired full trial reports of candidates for inclusion. The authors resolved any disagreements on eligibility by mutual consent, or by recourse to a third author. Two authors intended to independently extract study data from eligible studies into a data extraction form and compare the findings, synthesise data using risk ratios, and assess risk of bias using standard Cochrane methodologies. However, we found no eligible trials.

Main results: There were no randomised controlled trials that met the eligibility criteria. A number of potentially eligible studies are underway, and we will assess them for inclusion in the next update of this review.

Authors' conclusions: There is a lack of high-quality evidence, i.e. RCTs, that tests the effectiveness of cessation interventions in improving TB treatment outcomes. There is a need for good-quality randomised controlled trials that assess the effect of SCIs on TB treatment outcomes in both the short and long term. Establishing such an evidence base would be an essential step towards the implementation of SCIs in TB control programmes worldwide.

PubMed Disclaimer

Conflict of interest statement

KJ ‐ None known SK ‐ None known HDS ‐ None known HK ‐ None known SG ‐ None known

Figures

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Figure 1. Flow of information through different phases of the systematic review
See this image and copyright information in PMC

Update of

References

References to studies excluded from this review

Awaisu 2011 {published data only}
    1. Awaisu A, Mohamad HN, Noordin N, Muttalif A, Aziz N, Syed SS, et al. Impact of connecting tuberculosis directly observed therapy short‐course with smoking cessation on health‐related quality of life. Tobacco Induced Diseases 2012;10(1):2. - PMC - PubMed
    1. Awaisu A, Mohamed MH, Noordin NM, Aziz NA, Sulaiman SA, Muttalif AR, et al. The SCIDOTS Project: evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes. Substance Abuse Treatment 2011;6:26. - PMC - PubMed
Campbell 2014 {published data only}
    1. Campbell IA, Chaudhary RD, Holdsworth GM, Lyne OD. Brief advice to tuberculosis patients in Nepal to stop smoking:a pilot study by the Britain Nepal Medical Trust. International Journal for Tuberculosis and Lung Disease 2014;18(12):1438‐42. - PubMed
El Sony 2007 {published data only}
    1. Sony A, Slama K, Salieh M, Elhaj H, Adam K, Hassan A, et al. Feasibility of brief tobacco cessation advice for tuberculosis patients: a study from Sudan. International Journal of Tuberculosis and Lung Diseases 2007;11(2):150‐5. - PubMed
Kaur 2013 {published data only}
    1. Kaur J, Sachdeva KS, Modi B, Jain DC, Chauhan LS, Dave P, et al. Promoting tobacco cessation by integrating ‘brief advice’ in tuberculosis control programme. WHO South‐East Asia Journal Public Health 2013;2(1):28‐33. - PubMed
Louwagie 2014 {published data only}
    1. Louwagie GM, Okuyemi KS, Ayo‐Yusuf OA. Efficacy of brief motivational interviewing on smoking cessation at tuberculosis clinics in Tshwane, South Africa: a randomized controlled trial. Addiction 2014;109(11):1942‐52. - PubMed
Safdar 2015 {published data only}
    1. Safdar N, Zahid R, Shah S, Fatima R, Cameron K, SIddiqi K. Tuberculosis patients learning about second‐hand smoke (TBLASS): results of a pilot randomised controlled trial. International Journal for Tuberculosis and Lung Disease 2015;19(2):237‐43. - PubMed
Siddiqui 2013 {published data only}
    1. Siddiqi K, Khan A, Ahmad M, Dogar O, Kanaan M, Newell JN, et al. Action to Stop Smoking in Suspected Tuberculosis (ASSIST) in Pakistan. a cluster randomized, controlled trial. Annals of Internal Medicine 2013;159(9):667‐75. - PubMed

References to ongoing studies

CTRI/2013/07/003830 {unpublished data only}
    1. CTRI/2013/07/003830. Evaluation of different strategies (pharmacologic intervention versus enhancedmotivation vs. standard motivation) for smoking cessation in TB patients under treatmentin the revised national TB Programme – A cluster randomized effectiveness trial. http://www.nirt.res.in/pdf/AR/AR‐2013‐14.pdf accessed 12th January 2016.
Goel S {unpublished data only}
    1. Goel S, Garg A, Jeyashree K. Effect of smoking cessation intervention package on treatment outcomes in pulmonary tuberculosis patients: a cluster randomized controlled trial. Clinical trials registry of India. Publication pending.
IRCT2013062613783N1 {unpublished data only}
    1. IRCT2013062613783N1. Determining efficacy of smoke cessation program on quit Rate, immunological response and treatment outcome in new pulmonary tuberculosis patients: a clinical trial. http://www.irct.ir/searchresult.php?keyword=IRCT2013062613783N1&id=1... accessed 12th January 2016.
NCT01517022 {unpublished data only}
    1. NCT01517022. Intensive Smoking‐cessation Versus Basic Smoking‐cessation Advice in Smear‐positive Patients With Pulmonary Tuberculosis. https://clinicaltrials.gov/ct2/show/NCT01517022 accessed 12th January, 2016.
NCT02238405 {unpublished data only}
    1. NCT02238405. A Controlled Smoking Cessation Trial and Prospective Cohort Study of Tuberculosis (TB) Treatment Outcomes. https://clinicaltrials.gov/ct2/show/NCT02238405 accessed 12th January 2016.

Additional references

Balbay 2005
    1. Balbay O, Annakkaya AN, Arbak P, Bilgin C, Erbas M. Which patients are able to adhere to tuberculosis treatment? A study in a rural area in the northwest part of Turkey. Japanese Journal of Infectious Disease 2005;58(3):152‐8. - PubMed
Bates 2007
    1. Bate, MN, Khalakdina A, Pai M, Chang L, Lessa F, Smith KR. Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta‐analysis. Archives of Internal Medicine 2007;167(4):335‐42. - PubMed
Batista 2008
    1. Batista JL, Albuquerque M, Ximenes R, Rodrigues LC. Smoking increases the risk of relapse after successful tuberculosis treatment. International Journal of Epidemiology 2008;37(4):841‐51. - PMC - PubMed
Cahill 2012
    1. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 4. [DOI: 10.1002/14651858.CD006103.pub6] - DOI - PubMed
Den Boon 2005
    1. Boon S, Lill SW, Borgdorff MW, Verver S, Bateman ED, Lombard CJ, et al. Association between smoking and tuberculosis infection: a population survey in a high tuberculosis incidence area. Thorax 2005;60(7):555‐7. - PMC - PubMed
DiClemente 1991
    1. DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of consulting and Clinical Psychology 1991;59(2):295‐304. - PubMed
GATS India 2010
    1. Ministry of Health and Family Welfare, Government of India, International Institute of Population Sciences, Mumbai. Global Adult Tobacco Survey, GATS India 2009 ‐ 2010. www.mohfw.nic.in/WriteReadData/l892s/1455618937GATS%20India.pdf (Accessed 16th May 2014).
GTR 2011
    1. World Health Organization. WHO report 2011. Global Tuberculosis Control. apps.who.int/iris/bitstream/10665/44728/1/9789241564380_eng.pdf (Accessed on 18th May 2013).
GTR 2013
    1. World Health Organization, Geneva. Global Tuberculosis Report 2013. www.who.int/tb/publications/factsheet_global.pdf (Accessed 15th May 2014).
GTR 2014
    1. World Health Organization. Global Tuberculosis Report 2014. www.who.int/tb/publications/global_report/en/ (Accessed 10th May 2014). [ISBN 978 92 4 156480 9]
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hughes 2014
    1. Hughes JR, Stead LF, Hartmann‐Boyce J, Cahill K, Lancaster T. Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews 2014, Issue 1. [DOI: 10.1002/14651858.CD000031.pub4] - DOI - PMC - PubMed
Lancaster 2005
    1. Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. [DOI: 10.1002/14651858.CD001292.pub2] - DOI - PubMed
Lavigne 2006
    1. Lavigne M, Rocher I, Steensma C, Brassard P. The impact of smoking on adherence to treatment for latent tuberculosis infection. BMC Public Health 2006;6(1):66. - PMC - PubMed
Leung 2015
    1. Leung CC, Yew WW, Chan CK, Chang KC, Law WS, Lee SN, et al. Smoking adversely affects treatment response, outcome and relapse in tuberculosis. European Respiratory Journal 2015;45(3):738‐45. - PubMed
Lin 2007
    1. Lin HH, Ezzati M, Murray M. Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta‐analysis. PLoS Medicine 2007;4(1):e20. - PMC - PubMed
Lin 2009
    1. Lin H‐H, Ezzati M, Chang H‐Y, Murray M. Association between tobacco smoking and active tuberculosis in Taiwan:prospective cohort study. American Journal of Respiratory Critical Care Medicine 2009;180(5):475‐80. - PubMed
Maciel 2013
    1. Maciel EL, Brioschi AP, Peres RL, Guidoni LM, Ribeiro FK, Hadad DJ, et al. Smoking and 2‐month culture conversion during anti‐tuberculosis treatment. International Journal of Tuberculosis and Lung Disease 2013;17(2):225‐8. - PMC - PubMed
Maurya 2002
    1. Maurya V, Vijayan VK, Shah A. Smoking and tuberculosis: an association overlooked. International Journal of Tuberculosis and Lung Disease 2002;6(11):942‐51. - PubMed
MDG 2015
    1. United Nations General Assembly. United Nations Millennium Declaration. Fifty‐fifth session, Agenda item 60 (b). www.un.org/en/ga/search/view_doc.asp?symbol=A/RES/55/2 (Accessed 16th May 2013).
Nijenbandring de Boer 2014
    1. Nijenbandring de Boer R, Oliveira e Souza Filho JB, Cobelens F, Ramalho Dde P, Campino Miranda PF, Logo KD, et al. Delayed culture conversion due to cigarette smoking in active pulmonary tuberculosis patients. Tuberculosis (Edinburgh, Scotland) 2014;94(1):87‐91. - PubMed
Patra 2015
    1. Patra J, Bhatia M, Suraweera W, Morris SK, Patra C, Gupta PC, et al. Exposure to second‐hand smoke and the risk of tuberculosis in children and adults: a systematic review and meta‐analysis of 18 observational studies. PLoS Medicine 2015;12(6):e1001835. - PMC - PubMed
Schneider 2007
    1. Schneider NK, Novotny TE. Addressing smoking cessation in tuberculosis control. Bulletin of the World Health Organization 2007;85(10):820‐1. - PMC - PubMed
Shea 1992
    1. Shea S, Misra D, Ehrlich MH, Field L, Francis C. Correlates of nonadherence to hypertension treatment in an inner‐city minority population. American Journal of Public Health 1992;82(12):1607‐12. - PMC - PubMed
Slama 2007a
    1. Slama K, Chiang C‐Y, Enarson DA, Hassmiller K, Fanning A, Gupta P, et al. Tobacco and tuberculosis: a qualitative systematic review and meta‐analysis. International Journal of Tuberculosis and Lung DIsease 2007;11(10):1049‐61. - PubMed
Slama 2007b
    1. Slama K, Chiang CY, Enarson DA. Introducing brief advice in tuberculosis services. International Journal of Tuberculosis and Lung Disease 2007;11(5):496‐9. - PubMed
Stead 2005
    1. Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. [DOI: 10.1002/14651858.CD001007.pub2] - DOI - PubMed
Stead 2012a
    1. Stead LF, Lancaster T. Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 12. [DOI: 10.1002/14651858.CD009670.pub2] - DOI - PubMed
Stead 2012b
    1. Stead LF, Perera R, Bullen C, Mant D, Hartmann‐Boyce J, Cahill K, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 11. [DOI: 10.1002/14651858.CD000146.pub4] - DOI - PubMed
Stead 2013
    1. Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann‐Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2013, Issue 5. [DOI: 10.1002/14651858.CD000165.pub4] - DOI - PMC - PubMed
The Union 2007
    1. World Health Organization and International Union Against Tuberculosis and Lung Disease. A WHO/The Union Monograph on TB and Tobacco Control: Joining Efforts to Control Two Related Global Epidemics. Geneva: World Health Organization, 2007.
The Union 2008
    1. Slama K, Chlang C‐Y, Enarson DA. Tobacco Cessation Interventions for Tuberculosis Patients. A Guide for Low Income Countries. Paris, France: International Union Against Tuberculosis and Lung Disease, August 2008.
Wen 2010
    1. Wen C‐P, Chan T‐C, Chan H‐T, Tsai M‐K, Cheng T‐Y, Tsai S‐P. The reduction of tuberculosis risks by smoking cessation. BMC Infectious Diseases 2010;10(156):1‐9. [DOI: 10.1186/1471-2334-10-156] - DOI - PMC - PubMed
WHO 2009
    1. Brands A, Ottmani S‐E, Lonnroth K, Blanc LJ, Rahman K, Bettchera DW, et al. Reply to ‘Addressing smoking cessation in tuberculosis control’. Bulletin of the World Health Organization 2007;85(8):647‐8. - PMC - PubMed
WHO 2013
    1. World Health Organization (WHO). Definitions and Reporting Framework for Tuberculosis– 2013 revision (updated December 2014). apps.who.int/iris/bitstream/10665/79199/1/9789241505345_eng.pdf (accessed 7th January 2016).
WHO Factsheet 2009
    1. World Health Organization. Tuberculosis and Tobacco ‐ a strong association. www.who.int/tobacco/resources/publications/factsheet_tb_tobacco_sep09.pdf (Accessed 11th September 2013).
Wickstrom 2000
    1. Wickstrom G, Bendix T. The "Hawthorne effect" ‐ what did the original Hawthorne studies actually show?. Scandinavian Journal of Work and Environmental Health 2000;26(4):363‐7. - PubMed
Yaffe 2012
    1. Yaffe J, Montgomery P, Hopewell S, Shepard LD. Empty reviews: A description and consideration of Cochrane systematic reviews with no included studies. PLoS ONE 2012;7(5):3‐9. - PMC - PubMed

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