Contribution of Smoking to Pulmonary Tuberculosis Incidence in Bandung, Indonesia

Raspati Cundarani Koesoemadinata, Panji Fortuna Hadisoemarto, Manik Intan Gumilang, Ida Parwati Santoso, Bachti Alisjahbana


Background: Primary data reporting the contribution of smoking to tuberculosis (TB) incidence in Indonesia are scarce. This study aimed to estimate the effect of smoking on TB incidence and the risk of tuberculosis attribut­able to smoking among presumptive TB patients in Indonesia, a country with the third highest incidence of TB globally which one third of its population are active smokers.

Subjects and Method: Between 2012-2014, presumptive TB patients aged ≥15 years old presenting with cough for at least 2 weeks to Dr. Hasan Sadikin General Hospital Bandung, Indonesia underwent interview, chest x-ray examination, and were asked to provide 2 sputa for microscopic examination and Mycobacterium tuberculosisculture. The prevalence of smoking and bacteriologically confirmed TB among these patients and their corresponding confidence interval (CI) was determined. Dependent variable was TB. The independent variables were smoking, age, and gender. A multiple logistic regression was used to assess the association between smoking category with bacteriologically confirmed TB controlling for age and gender.

Results: Of 198 presumptive TB patients (58.1% males, median age 40 years old), 101 (51.0%; 95% CI= 43.8 to 58.2) were ever-smoker and 71 (35.9%; 95% CI= 29.2 to 43.0) had bacte­riologically confirmed TB. Ever-smoking was associated with an increase bac­teriologically confirmed TB incidence (aOR= 2.95; 95% CI= 1.36 to 6.40; p= 0.006). The incidence of bacteriologically confirmed TB that was attributable to smoking (population attributable proportion) was 22.3% (95% CI= 16.6 to 28.7).

Conclusion: Smoking increases risk of acquiring TB. Smoking cessation program should be promoted as an intervention to reduce TB incidence and prevent TB transmission.

Keywords: smoking, TB, attributable proportion


Raspati Koesoemadinata. Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia. Mobile: 082218307880. Email: r.c.koesoemadinata@­

Journal of Epidemiology and Public Health (2020), 05(04): 451-457

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