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Study: Anti-smoking Strategies Critical to TB and HIV Care

FILE - Patients with tuberculosis (TB) and HIV wear masks while awaiting consultation at a clinic in Cape Town's Khayelitsha township, South Africa.
FILE - Patients with tuberculosis (TB) and HIV wear masks while awaiting consultation at a clinic in Cape Town's Khayelitsha township, South Africa.

A new study calls for urgent action to integrate anti-smoking strategies into the care of people being treated for tuberculosis and HIV.

The International Union Against Tuberculosis and Lung Disease released a report recently arguing that second-hand smoke must be addressed in the treatment of patients with TB and HIV. The research identifies a critical missed opportunity in TB and HIV programs: smoking and exposure to second hand smoke are known to exacerbate these diseases.

The lead author of the report, Dr. Angela Jackson-Morris, said, “For some years, the Union and other organizations attempted to get the message across that TB and HIV care must start to incorporate the anti-smoking strategies.

“We know that more people who smoke end up having TB, and treatment is less effective. We know that there are more smokers amongst people with TB and HIV. And we know that treatment… for anti-retro-viral therapies is less effective if people smoke,” she added.

Jackson-Morris said it is a critical omission because TB and HIV treatment fails patients unless it incorporates preventive measures that will actually allow them to have a good quality of life.

The study describes practical, low-cost and effective measures identified by the World Health Organization. Jackson-Morris stressed that these measures should be incorporated immediately into treatment programs.

“They’re things like monitoring whether the patients that you see are smokers or ex-smokers… so that you can then follow-up with them and the other healthcare workers can provide appropriate support,” she said.

The most important strategy is to identify smokers and give them the support they need to stop smoking.

It is also important to offer them a smoke-free health facility served by staff who do not smoke. If the health workers perform house calls, they have a chance to encourage the patient’s family and friends to stop smoking around the patient.

“And explain to them that effectively their loved one, their family member, won’t get better from TB and won’t be successful on their anti-retroviral therapy if they’ve still got this second-hand smoke around them,” Jackson-Morris said.

“We know very clearly from all of the evidence that brief advice from a healthcare worker … can be the most effective way to get others to quit smoking,” she said.

She added that the advice requires repeated follow-up.

Managers of health care facilities must also avoid pressure from tobacco industry representatives to take sponsorship of their product, said Jackson-Morris.

“That way, people aren’t inadvertently exposed to tobacco advertising when they go, for example to their local clinic,” she said.