Friday, 7 October 2011

TB as a smoking-related disease

Says the BBC. Ahead of either the National Health Service or the Center for Disease Control, they report this tenuous link as fact. Links come from Chris Snowdon, who correctly points out that tuberculosis is associated with infection. Risk factors include certain medical conditions and proximity to a source of infection. The disease is contagious, but does not spread rapidly.

A study has just come out linking mortality from tuberculosis and projecting 'extra' deaths in future years with increasing smoking rates in affected areas. Tobacco control appears to be the solution once again:
Tobacco smoking could substantially increase tuberculosis cases and deaths worldwide in coming years, undermining progress towards tuberculosis mortality targets. Aggressive tobacco control could avert millions of deaths from tuberculosis.
Astonishingly a spokesman for the British Lung Foundation commented thus:
"Concerted international efforts are now under way to try and turn the tide of TB, but this important research shows that all these efforts may be undermined by the tobacco industry's continuing aggressive promotion of smoking in many parts of the world."
Do these people never give up? As if it weren't enough trying to divert all health resources to the supposed scourge of tobacco, the global health crusade now attempts to give the impression that communicable disease control is also best managed by 'aggressive' action against tobacco companies. Is all disease control from now on to address lifestyle issues at the expense of all else?

(In certain indoor settings of course there are technological solutions available to prevent the spread of contagious disease, including TB. Although these systems have been in use in health care in the UK for many years, they are unlikely to satisfy anti-tobacco crusaders in the health service – these people deny that the air-cleaning systems could deal effectively with tobacco smoke, so how can they be expected to deal with mycobacterium tuberculosis?)


Anonymous said...

So do you want the fact that smoking demonstrably increases the likelihood of developing TB to be hidden from smokers?

That seems to be very unfair to smokers.

Anonymous said...

LOOK at the authors! Stanton A. Glantz, California, USA.

It figues.


The Pub Consultancy Service said...

It's no wonder your post is anonymous what a ridiculous statement. As has been said TB is an infectious disease, if the disease exists in a community there will be very many groups of people susceptible to it, diabetics, the elderly, children, cancer patients, in fact anyone whose immune system is not up to scratch.

In the UK TB was all but eradicated but is now starting to grow in the immigrant Asian community, and has absolutely nothing to do with smoking by hygiene standards.

So please so called health care professionals stop blaming Tobacco for your own inability to eradicate a disease that in the 21st Century should already be like the Dodo.

Life Long Never Smoker.

Belinda said...

Smoking was so far down the list of factors for TB that it wasn't even included in the NHS and CDC descriptions of risk factors for the disease. World Health Organisation emphasises the link But WHO has a mission to eradicate tobacco worldwide that is at odds with its mission as a global health body. As the commenter above points out anyone with a weakened immune system will be vulnerable if TB is in the community and this may or may not include smokers.

Anonymous said...


"Tiny levels of nicotine kill the tuberculosis bacterium, researchers in Florida have discovered. They say it might be possible to use nicotine to treat the growing problem of drug-resistant forms of TB.

"The amount of nicotine needed to kill the bacteria is less than in one cigarette," says Saleh Naser of the University of Central Florida, who presented his results at a meeting of the American Society for Microbiology in Orlando on Monday."

"Other researchers are sceptical. "Lots of patients smoke and still get the disease," says Salman Siddici of the company Bectin Dickinson, who has worked on TB. "Many drugs inhibit growth in the lab but don't work in vivo."

Naser made the discovery by chance. A colleague of his inserted a gene for a protein into tobacco plants, to see if it would kill the TB bacterium.

But when Naser tested the antibactericidal properties of these plants, he found normal tobacco was just as effective at killing cells. Further studies showed nicotine was responsible for the effect.

Naser and his colleague George Ghobrial found that as little as 0.27 micrograms of nicotine per millilitre was enough to kill Mycobacterium tuberculosis. It was also effective against other strains of Mycobacteria.

Naser says that smoking doesn't work because the level of nicotine fluctuates so much. "The dosage is wrong," he says."

And we set fire to it.

There is some historical evidence and a few other studies.

And if they are true, we might have needed all those swine flu vaccines if we hadn't suddenly stopped gathering together in enclosed public spaces.


Bill Gibson said...

Prepare for the introduction of another vaccine or more likely a cull. Trust your Vet, not your Chief Medical Officer

Anonymous said...

None of the bluster in the posts here negates the finding that smoking is one of the factors that makes people more susceptible to TB.

The original article points to the big risk of large scale deaths from the disease being in less developed parts of the world. not the UK.

Surely the potential victims in these parts of the world should at least have all the facts so that they can take some control over their lives in an effort to avoid TB.

This blog, and most of the posters so far, just want to sweep this under the carpet.

(And, for the benefit of the poster who thinks that smoking kills the TB bacteria you should remember that killing bacteria in a lab dish is very different to killing them in the body. Domestos kills all known germs - dead, but drinking it, or even inhaling it, won't clear up a TB infection.)

Belinda said...

Anonymous: No one here is attempting to brush risk factors under the carpet. Neither CDC nor NHS included smoking as a risk factor in TB, but you're not accusing them of hiding the truth. Look at the risk factors they list.

It seems to be axiomatic in tobacco control circles that smokers should be encouraged to stop smoking but should not be expected to influence their life chances in any other way. Smoking may weaken the immunity of some people to the bacteria (although many other conditions weaken it much more) ... but surely the way to go is *primarily* fighting infection from the bacteria.

Citing TB as an excuse for aggressive control seems a 'rather round the houses' reason for tackling both TB and tobacco consumption.

Belinda said...

Edit: Citing TB as an excuse for aggressive _tobacco_ control seems a 'rather round the houses' reason for tackling both TB and tobacco consumption.

John S said...

In a study among immigrants in London from the Indian subcontinent (Vegetarian diet as a risk factor for tuberculosis in immigrant south London Asians.
D P Strachan, K J Powell, A Thaker, F J Millard, and J D Maxwell), vegetarian Hindu Asians were found to have an 8.5 fold increased risk of tuberculosis, compared to Muslims who ate meat and fish daily.

How many TB deaths will be attributable to vegetarianism?