Smoking Exposure and the Risk of Latent Tuberculosis Infection: Results from NHANES 2011–2012

Abstract

The association between smoking exposure and latent tuberculosis infection (LTBI) has been investigated in a few studies; however, further investigation is needed. In this study, the 2011–2012 NHANES population was used to evaluate smoking exposure and LTBI risk. A total of 7042 participants with available LTBI results and without active tuberculosis were included for analysis. Smoking was defined as participants who smoked at least 100 cigarettes in their life. Both univariable and multivariable analysis were adopted to evaluate smoking exposure, as well as related factors on the risk of LTBI. LTBI rates among current smokers (12.1%) and former smokers (9.9%) were higher than non-smokers (5.9%). However, current smokers and former smokers were not significantly associated with LTBI risk when compared to non-smokers after adjusting by age and sex in the multivariable analysis. Meanwhile, we found that passive smoking was not associated with LTBI (adjusted odds ratio (AOR), 0.85; 95%CI, 0.66–1.09). In multivariable analysis, current smoking was associated with LTBI (OR, 1.67; 95%CI, 1.28–2.19), while former smokers had an increased OR of LTBI, but the OR did not reach statistical significance (OR, 1.15; 95%CI, 0.90–1.48). Household tuberculosis (TB) contact was also related to LTBI (OR, 1.93; 95%CI, 1.25–2.99). However, BMI and diabetes were not found to be associated with LTBI. Smoking, especially current smoking, was significantly associated with LTBI. LTBI screening should be recommended for active smokers. Former smoking and passive smoking exposure were not found to have a significant relationship with LTBI risk. However, the high LTBI rate among quitters indicated we should pay more attention to former smokers with LTBI.

Keywords

• tuberculosis
• latent tuberculosis infection
• smoking
• NHANES
• cotinine