Tobacco use and nicotine dependence among newly diagnosed pulmonary tuberculosis patients in Ballabgarh tuberculosis unit, Haryana

J Family Med Prim Care. 2020 Jun 30;9(6):2860-2865. doi: 10.4103/jfmpc.jfmpc_373_20. eCollection 2020 Jun.


Introduction: This study was conducted to estimate the burden of tobacco use and nicotine dependence among newly diagnosed pulmonary tuberculosis patients to help inform effective implementation of tobacco cessation strategies among tuberculosis patients to improve treatment outcomes.

Materials and methods: This was a cross-sectional study conducted among 211 consecutive newly diagnosed pulmonary tuberculosis patients between July 2018 till January 2019 at Ballabgarh tuberculosis unit (TU) in Faridabad district of Haryana, India. All participants were administered a pre-tested questionnaire to assess tobacco use and the Fagerstrom test for nicotine dependence (FTND) to assess nicotine dependence. Current tobacco users were defined as those who smoked in the past 7 days. Nicotine dependence was classified as low, moderate, or high for the FTND score of 0-3, 4-6, and 7-10, respectively.

Results: Majority of the participants (71.1%) were male, aged 26-50 years (45.5%), and married (65.4%). Fifty (23.7%, CI: 18.0-29.4) participants were currently using tobacco; 29 (13.7%, CI: 9.1-18.4) reported smoking tobacco while 23 (10.9%, CI: 6.7-15.1) reported using smokeless tobacco. In the last month, the proportion of patients who attempted to quit smoking and smokeless tobacco was 31% and 26.1%, respectively. 86.2% of the smokers and 69.6% smokeless tobacco users reported moderate to a high level of nicotine dependence.

Conclusion: High prevalence of tobacco use, a higher level of nicotine dependence and inability to quit despite an attempt among a large number of tuberculosis patients, necessitates the inclusion of routine tobacco cessation advice and nicotine replacement therapy in tuberculosis care.

Keywords: India; nicotine dependence; smoking; tobacco; tuberculosis.