Smoking among tuberculosis patients in Kerala, India: Proactive cessation efforts are urgently needed

A. S. Pradeepkumar, K. R. Thankappan, M. Nichter

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


objectives: To document smoking patterns among tuberculosis (TB) patients at eight different points of time before, during and after treatment, and to investigate the frequency and content of the quit smoking messages they received. DESIGN: A stratified random sample of 215 male TB patients from Kerala, India, who had completed treatment in the previous 9 months was surveyed using a pretested semi-structured interview schedule. RESULTS: Six months prior to diagnosis, 94.4 % of male TB patients were ever smokers and 71.2% were current smokers. Although 87% of patients had quit smoking soon after diagnosis, 36% had relapsed by 6 months post treatment. One third relapsed during the first 3 months of treatment and another third during the next 3 months of treatment. Two thirds of all smokers received cessation advice from primary care physicians, but less than half received advice from others. Less than half of all messages were TB-specific; the rest were very general short instructions. Smoking more than 15 cigarettes/ bidis at the time of diagnosis was significantly associated with a lower quit rate during treatment (OR 8.0,95%CI 2.1-30.9). CONCLUSION: Messages to not smoke often go unheeded among TB patients. Proactive efforts are needed to encourage health staff and DOTS providers to give strong cessation messages.

Original languageEnglish (US)
Pages (from-to)1139-1145
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number10
StatePublished - Oct 2008


  • Cessation
  • Kerala
  • Patients
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases


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