Supporting tobacco cessation in tuberculosis patients.

Abstract Tobacco is a key determinant of health inequalities, both across and within countries. 80% of tobacco users live in economically developing countries, which also face a huge tuberculosis (TB) burden. TB being an archetypal disease, affects low income groups, and has a higher proportion of smokers than the general population. The sub-group of TB patients who smoke disproportionately suffer from poorer outcomes, despite treatment. Behavioural interventions aimed at helping smokers quit by modifying their health beliefs and attitudes are highly successful in TB patients. However, integrating them in routine TB care is challenging, and requires a cultural shift at several levels, including individual, structural and organisational. We offer recommendations for policy, practice and research to address the dual burden of tobacco use and TB. Acting on these are vital towards achieving the United Nations (UN) Sustainable Development Goal (SDG) target of ending the TB epidemic by 2030.