Smoking cessation and smokefree environments for tuberculosis patients in Indonesia-a cohort study

Tara Singh Bam, Tjandra Yoga Aditama, Chen Yuan Chiang, Rubaeah Rubaeah, Acep Suhaemi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Research indicates that smoking substantially increases the risk of tuberculosis (TB), delay in diagnosis, failure of TB treatment and death from TB. Quitting smoking is one of the best ways to prevent unwanted outcomes. Exposure to secondhand smoke increases the risks of both TB infection and development of active TB disease among children and adults. TB patients who smoke in the home are also placing their families at a greater risk of TB infection. It is very important to keep homes smokefree. The present study assessed the implementation and effectiveness of an intervention that promotes smoking cessation and smokefree environments for TB patients. Methods: All consecutive new sputum smear-positive TB patients (aged ≥15 years old) diagnosed and registered in 17 health centres between 1 January 2011 and 31 December 2012 were enrolled. The ABC (A=ask, B=brief advice, C=cessation support) intervention was offered for 5 to 10 minutes within DOTS services at each visit. Smoking status and smokefree environments at home were assessed at the first visit, each monthly follow up and at month six. Factors associated with quitting were analysed by univariable and multivariable analysis Results: Of the 750 TB patients registered, 582 (77.6 %) were current smokers, 40 (5.3 %) were ex-smokers and 128 (17.1 %) were never smokers. Of the 582 current smokers, 66.8 % had quit smoking at month six. A time from waking to first cigarette of >30 minutes, having a smokefree home and the display of "no smoking" signage at home at month six were significantly associated with quitting. Of the 750 TB patients, 86.1 % had created a smokefree home at six month follow-up compared with 18.5 % at baseline. All 80 health facilities were 100 % tobacco-free at the end of 2012 compared with only 52 (65 %) when the intervention began in March 2011. Conclusions: Brief advice of 5-10 minutes with minimal cessation support at every visit of TB patients resulted in high quit rates and higher awareness of adverse health effects of secondhand smoke exposure, which led patients to make their homes smokefree and health providers to make health care tobacco-free.

Original languageEnglish
Article number604
JournalBMC Public Health
Volume15
Issue number1
DOIs
Publication statusPublished - Jul 2 2015

Fingerprint

Indonesia
Smoking Cessation
Tuberculosis
Cohort Studies
Smoking
Tobacco Smoke Pollution
Tobacco
Health
Health Facilities
Infection
Sputum
Treatment Failure
Smoke
Tobacco Products

Keywords

  • ABC-approach
  • Cessation
  • Smokefree home
  • Smoking
  • Tuberculosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Smoking cessation and smokefree environments for tuberculosis patients in Indonesia-a cohort study. / Bam, Tara Singh; Aditama, Tjandra Yoga; Chiang, Chen Yuan; Rubaeah, Rubaeah; Suhaemi, Acep.

In: BMC Public Health, Vol. 15, No. 1, 604, 02.07.2015.

Research output: Contribution to journalArticle

Bam, Tara Singh ; Aditama, Tjandra Yoga ; Chiang, Chen Yuan ; Rubaeah, Rubaeah ; Suhaemi, Acep. / Smoking cessation and smokefree environments for tuberculosis patients in Indonesia-a cohort study. In: BMC Public Health. 2015 ; Vol. 15, No. 1.
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abstract = "Background: Research indicates that smoking substantially increases the risk of tuberculosis (TB), delay in diagnosis, failure of TB treatment and death from TB. Quitting smoking is one of the best ways to prevent unwanted outcomes. Exposure to secondhand smoke increases the risks of both TB infection and development of active TB disease among children and adults. TB patients who smoke in the home are also placing their families at a greater risk of TB infection. It is very important to keep homes smokefree. The present study assessed the implementation and effectiveness of an intervention that promotes smoking cessation and smokefree environments for TB patients. Methods: All consecutive new sputum smear-positive TB patients (aged ≥15 years old) diagnosed and registered in 17 health centres between 1 January 2011 and 31 December 2012 were enrolled. The ABC (A=ask, B=brief advice, C=cessation support) intervention was offered for 5 to 10 minutes within DOTS services at each visit. Smoking status and smokefree environments at home were assessed at the first visit, each monthly follow up and at month six. Factors associated with quitting were analysed by univariable and multivariable analysis Results: Of the 750 TB patients registered, 582 (77.6 {\%}) were current smokers, 40 (5.3 {\%}) were ex-smokers and 128 (17.1 {\%}) were never smokers. Of the 582 current smokers, 66.8 {\%} had quit smoking at month six. A time from waking to first cigarette of >30 minutes, having a smokefree home and the display of {"}no smoking{"} signage at home at month six were significantly associated with quitting. Of the 750 TB patients, 86.1 {\%} had created a smokefree home at six month follow-up compared with 18.5 {\%} at baseline. All 80 health facilities were 100 {\%} tobacco-free at the end of 2012 compared with only 52 (65 {\%}) when the intervention began in March 2011. Conclusions: Brief advice of 5-10 minutes with minimal cessation support at every visit of TB patients resulted in high quit rates and higher awareness of adverse health effects of secondhand smoke exposure, which led patients to make their homes smokefree and health providers to make health care tobacco-free.",
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AU - Bam, Tara Singh

AU - Aditama, Tjandra Yoga

AU - Chiang, Chen Yuan

AU - Rubaeah, Rubaeah

AU - Suhaemi, Acep

PY - 2015/7/2

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N2 - Background: Research indicates that smoking substantially increases the risk of tuberculosis (TB), delay in diagnosis, failure of TB treatment and death from TB. Quitting smoking is one of the best ways to prevent unwanted outcomes. Exposure to secondhand smoke increases the risks of both TB infection and development of active TB disease among children and adults. TB patients who smoke in the home are also placing their families at a greater risk of TB infection. It is very important to keep homes smokefree. The present study assessed the implementation and effectiveness of an intervention that promotes smoking cessation and smokefree environments for TB patients. Methods: All consecutive new sputum smear-positive TB patients (aged ≥15 years old) diagnosed and registered in 17 health centres between 1 January 2011 and 31 December 2012 were enrolled. The ABC (A=ask, B=brief advice, C=cessation support) intervention was offered for 5 to 10 minutes within DOTS services at each visit. Smoking status and smokefree environments at home were assessed at the first visit, each monthly follow up and at month six. Factors associated with quitting were analysed by univariable and multivariable analysis Results: Of the 750 TB patients registered, 582 (77.6 %) were current smokers, 40 (5.3 %) were ex-smokers and 128 (17.1 %) were never smokers. Of the 582 current smokers, 66.8 % had quit smoking at month six. A time from waking to first cigarette of >30 minutes, having a smokefree home and the display of "no smoking" signage at home at month six were significantly associated with quitting. Of the 750 TB patients, 86.1 % had created a smokefree home at six month follow-up compared with 18.5 % at baseline. All 80 health facilities were 100 % tobacco-free at the end of 2012 compared with only 52 (65 %) when the intervention began in March 2011. Conclusions: Brief advice of 5-10 minutes with minimal cessation support at every visit of TB patients resulted in high quit rates and higher awareness of adverse health effects of secondhand smoke exposure, which led patients to make their homes smokefree and health providers to make health care tobacco-free.

AB - Background: Research indicates that smoking substantially increases the risk of tuberculosis (TB), delay in diagnosis, failure of TB treatment and death from TB. Quitting smoking is one of the best ways to prevent unwanted outcomes. Exposure to secondhand smoke increases the risks of both TB infection and development of active TB disease among children and adults. TB patients who smoke in the home are also placing their families at a greater risk of TB infection. It is very important to keep homes smokefree. The present study assessed the implementation and effectiveness of an intervention that promotes smoking cessation and smokefree environments for TB patients. Methods: All consecutive new sputum smear-positive TB patients (aged ≥15 years old) diagnosed and registered in 17 health centres between 1 January 2011 and 31 December 2012 were enrolled. The ABC (A=ask, B=brief advice, C=cessation support) intervention was offered for 5 to 10 minutes within DOTS services at each visit. Smoking status and smokefree environments at home were assessed at the first visit, each monthly follow up and at month six. Factors associated with quitting were analysed by univariable and multivariable analysis Results: Of the 750 TB patients registered, 582 (77.6 %) were current smokers, 40 (5.3 %) were ex-smokers and 128 (17.1 %) were never smokers. Of the 582 current smokers, 66.8 % had quit smoking at month six. A time from waking to first cigarette of >30 minutes, having a smokefree home and the display of "no smoking" signage at home at month six were significantly associated with quitting. Of the 750 TB patients, 86.1 % had created a smokefree home at six month follow-up compared with 18.5 % at baseline. All 80 health facilities were 100 % tobacco-free at the end of 2012 compared with only 52 (65 %) when the intervention began in March 2011. Conclusions: Brief advice of 5-10 minutes with minimal cessation support at every visit of TB patients resulted in high quit rates and higher awareness of adverse health effects of secondhand smoke exposure, which led patients to make their homes smokefree and health providers to make health care tobacco-free.

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KW - Tuberculosis

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