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Description
Nearly one-third (2.3 billion cases) of the world is infected with latent tuberculosis infection (LTBI), making the prevention and control of this disease one of the top public health priorities. Smoking tobacco is a major risk factor for tuberculosis morbidity and mortality and is a critical point to intervene. The act of smoking creates a local inflammatory response in the lungs, while the nicotine in tobacco suppresses the immune response to that inflammation. Tuberculosis is unequally distributed according to demographic and geographic factors and has been found to be more prevalent among ethnic-minorities that are foreign-born. In the United States, Hispanics are the largest foreign-born populations originating from countries that have higher endemic incidence rate of tuberculosis. However, there is little known about the relationship between ever-smoking and tuberculosis among Hispanics and specifically when differentiating between multiple types of Hispanics. This study investigates the association between ever-smoking and tuberculosis among Hispanic subgroups residing in the United States and surveyed using data from the Hispanic Health and Nutrition Examination Survey (HHANES) conducted by the National Institutes of Health (NIH). This study has a main dependent and outcome variable of whether a participant had ever been told by a doctor that they had tuberculosis. The main independent variable was ever-smoking at least 100 cigarettes in their life while testing other variables, diabetes, per capita income, age, gender, foreign birth, and educational level, for confounding relationships. Wald Chi-Square and logistic regression were used to analyze the data. After adjusting for all other variables, Mexican Americans with a history of smoking were 1.21 (95% CI 0.98-1.48) times more likely to have been diagnosed with TB by their doctor than those without a history of smoking. Cuban Americans with a history of smoking were 1.06 (95% CI 0.20-5.51) times more likely to have been diagnosed with TB by their doctor than those without a history of smoking. Puerto Ricans with a history of smoking were 1.18 (95% CI 0.51-2.78) times more likely to have been diagnosed with TB by their doctor compared to those without a history of smoking. Although results did not reach statistical significance, smoking cessation may be an effective measure to both prevent and control tuberculosis.
