%0 Journal Article
%T Tobacco Use or Body Mass ¨C Do They Predict Tuberculosis Mortality in Mumbai, India? Results from a Population-Based Cohort Study
%A Mangesh S. Pednekar
%A Matti Hakama
%A Prakash C. Gupta
%J PLOS ONE
%D 2012
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0039443
%X Tobacco use and under-nutrition are major public health concerns and tuberculosis is a major cause of morbidity and mortality in India. Using a cohort of 148,173 persons (recruited 1991¨C1997 and followed-up 1997¨C2003) the joint effects of tobacco use and BMI on tuberculosis mortality was studied. Tobacco use in any form and low-BMI had joint effect on tuberculosis mortality and the interaction effect was synergistic in men and antagonistic in women. Self-reported tuberculosis was associated with increased risk of tuberculosis mortality. In contrast, no such association was observed for self-reported diabetes persons. The risk pattern remained unchanged even after excluding tuberculosis deaths occurred within 1st two years of follow-up. This study highlights importance of age consideration of individual while excluding early deaths. Around 27% male tuberculosis deaths were attributable to their being underweight and smoker, while 22% male and 37% female deaths were attributable to their being underweight and smokeless tobacco user.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0039443