***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Smoking is known to aggravate tuberculosis ( TB ) , but such information has been ignored in clinical practice , as it was not thought to be relevant . The aim of this study is to assess the benefits of smoking cessation on TB mortality reduction . Methods The study attempts to quantify smokers ' risks on subsequent TB mortality and the change in such risks after smokers quit smoking . In this prospect i ve cohort study , the TB mortality risks of smokers , never smokers and former smokers were compared , by using the Cox proportional model to estimate the hazard ratio ( HR ) of TB.The cohort , consisting of 486,341 adults , participated in st and ard medical screening programs since 1994 , including 5,036 with self-reported TB history . Of 15,268 deaths identified as of 2007 , 77 were coded as TB  . Results Smokers with self-reported TB history ( 1.2 % ) had very high TB mortality ( HR = 44.02 ) . Among those without self-reported TB history , smoking increased TB mortality by nine-fold ( HR = 8.56 ) , but when they quit smoking , the risk was reduced by more than half ( 65 % ) , to a level not different from those who had never smoked . The overwhelming majority of TB deaths ( 83 % ) occurred among those without self-reported TB history . Given the high smoking prevalence and the high HR , smoking accounted for more than one-third ( 37.7 % ) of TB mortality in Taiwan . Smokers reported less TB history but died more from TB than those who had never smoked . Conclusions Smokers had very high TB mortality , as much as nine times those who had never smoked , but once they quit , the risk reduced substantially and was similar to those who never smoked . Smoking cessation has benefits to the smokers far beyond reducing TB risk , but successful tobacco control could favorably impact the TB mortality rate and reduce this public health burden , which has long haunted the Taiwanese population . Smoking cessation could reduce nearly one-third of tuberculosis deaths The impact of smoking on tuberculosis outcome was evaluated in a territory-wide treatment programme . 16 345 consecutive patients undergoing chemotherapy for active tuberculosis in government chest clinics in Hong Kong from 2001 to 2003 were followed up prospect ively for 2 years for treatment outcome and subsequently tracked through the territory-wide tuberculosis notification registry for relapse until the end of 2012 . Smoking was associated with more extensive lung disease , lung cavitation and positive sputum smear and culture at the baseline . In both current smokers and ex-smokers  , sputum smears and cultures were significantly more likely to remain positive after 2 months of treatment . Both categories of smokers were significantly less likely to achieve cure or treatment completion within 2 years . Overall , 16.7 % of unsuccessful treatment outcomes were attributable to smoking , with the key contributor being default in current smokers and death in ex-smokers . Among successful treatment completers , there was a clear gradient ( hazard ratios of 1.00 , 1.33 and 1.63 ) of relapse risk from never-smokers to ex-smokers and current smokers , with an overall population attributable risk of 19.4 % ( current smokers : 12.2 % ; ex-smokers : 7.2 % ) . Smoking adversely affects baseline disease severity , bacteriological response , treatment outcome and relapse in tuberculosis . Smoking cessation likely reduces relapse and secondary transmission . Smoking adversely affects treatment response in TB . Smoking cessation reduces relapse and secondary transmission . Background With evolving evidence of association between tuberculosis ( TB ) and tobacco smoking , recommendations for the inclusion of tobacco cessation interventions in TB care are becoming increasingly important and more widely disseminated . Connecting TB and tobacco cessation interventions has been strongly advocated as this may yield better outcomes . However , no study has documented the impact of such connection on health-related quality of life ( HRQoL ) . The objective of this study was to document the impact of an integrated TB directly observed therapy short-course ( DOTS ) plus smoking cessation intervention ( SCI ) on HRQoL. Methods This was a multi-centered non-r and omized controlled study involving 120 TB patients who were current smokers at the time of TB diagnosis in Malaysia . Patients were assigned to either of two groups : the usual TB-DOTS plus SCI ( SCIDOTS group ) or the usual TB-DOTS only ( DOTS group ) . The effect of the novel strategy on HRQoL was measured using EQ-5D question naire . Two-way repeated measure ANOVA was used to examine the effects . Results When compared , participants who received the integrated intervention had a better HRQoL than those who received the usual TB care . The SCIDOTS group had a significantly greater increase in EQ-5D utility score than the DOTS group during 6 months follow-up ( mean ± SD = 0.98 ± 0.08 vs. 0.91 ± 0.14 , p = 0.006 ) . Similarly , the mean scores for EQ-VAS showed a consistently similar trend as the EQ-5D indices , with the scores increasing over the course of TB treatment . Furthermore , for the EQ-VAS , there were significant main effects for group [ F ( 1 , 84 ) = 4.91 , p = 0.029 , η2 = 0.06 ] , time [ F ( 2 , 168 ) = 139.50 , p = < 0.001 , η2 = 0.62 ] and group x time interaction [ F ( 2 , 168 ) = 13.89 , p = < 0.001 , η2 = 0.14 ] . Conclusions This study supports the evidence that an integrated TB-tobacco treatment strategy could potentially improve overall quality of life outcomes among TB patients who are smokers Background There is substantial evidence to support the association between tuberculosis ( TB ) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation . Therefore , connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes . However , no study has extensively documented the evidence of benefits of such integration . SCIDOTS Project is a study from the context of a developing nation aim ed to determine this . Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course ( DOTS ) providers at five chest clinics in Malaysia . The study was a prospect i ve non-r and omized controlled intervention using quasi-experimental design . Using Transtheoretical Model approach , 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups : conventional TB DOTS plus smoking cessation intervention ( integrated intervention or SCIDOTS group ) or conventional TB DOTS alone ( comparison or DOTS group ) . At baseline , newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group , while those who were contemplating quitting were assigned to the comparison group . Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group . The impacts of the novel approach on biochemically vali date d smoking cessation and TB treatment outcomes were measured periodically as appropriate . Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group . At the end of 6 months , patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who received the conventional TB treatment alone ( 77.5 % vs. 8.7 % ; p < 0.001 ) . Furthermore , at the end of TB treatment ( 6 months or later ) , there were significantly higher rates of treatment default ( 15.2 % vs. 2.5 % ; p = 0.019 ) and treatment failure ( 6.5 % vs. 0 % ; p = 0.019 ) in the DOTS group than in the SCIDOTS group . Conclusion This study provides evidence that connecting TB-tobacco treatment strategy is significant among TB patients who are smokers . The findings suggest that the integrated approach may be beneficial and confer advantages on short-term outcomes and possibly on future lung health of TB patients who quit smoking . This study may have important implication s on health policy and clinical practice related to TB management among tobacco users BACKGROUND Passive smoking is associated with tuberculosis ( TB ) . Measures are required to protect non-smoking TB patients from second-h and smoke ( SHS ) . SETTING We developed a behavioural intervention to encourage TB patients to implement smoking restrictions at home in Pakistan . OBJECTIVES To assess the likelihood of such an intervention being successful and to inform a definitive trial in future . DESIGN This was a pilot r and omised controlled trial in which non-smoking TB patients were r and omised to receive either individual-based support or individual-based support combined with family reminders . We recruited patients living with at least one smoker in their homes . Our primary outcome was urinary cotinine level as a measure of SHS exposure 2 months post-r and omisation . RESULTS Of 273 patients assessed for eligibility , 150 ( 56 % ) patients were recruited and all but one were retained throughout the trial . A statistically significant absolute reduction was observed in non-smoking participants ' exposure to SHS based on urinary cotinine levels in both Arm 1 ( 71 % , 95%CI 61 - 79 ) and Arm 2 ( 76 % , 95%CI 67 - 83 ) between baseline and follow-up at 2 months . CONCLUSIONS The recruitment and retention rates for trial participants make it feasible to conduct a definitive trial in future . The observed effect size makes it worthwhile to conduct such a trial Background : An association between smoking and poor tuberculosis ( TB ) treatment outcomes has been globally established . Various smoking cessation interventions ( SCIs ) have been proven worldwide to curb smoking behavior . There is a need for evidence to assess if SCI increases the chance of successful treatment outcome among TB patients . Objectives : To assess the effectiveness of a brief SCI ; The Ask , Brief , Cessation support ( ABC ) package , on treatment outcomes and smoking cessation in smear-positive adult pulmonary TB patients . Methods : A cluster , r and omized controlled trial was conducted wherein 17 design ated microscopic centers of Ch and igarh , India were r and omly assigned using a computer-generated r and omization sequence to receive SCI within directly observed treatment , short ( DOTS ) services , or existing st and ard of care . Eligible and consenting smokers ( 15 + years ) registered as smear-positive pulmonary TB for DOTS ( n = 156 ) between January and June 2013 were enrolled .  Smoking cessation ( self-reported ) was assessed at intervals till the end of treatment . End TB treatment outcomes were extracted from patient records . Results : Treatment success was lower in intervention arm ( 83.6 % ) as compared control arm ( 88.2 % ) , but the difference was statistically insignificant ( P = 0.427 ) . Smoking cessation was higher in intervention arm ( 80.2 % ) compared to comparison arm ( 57.5 % ) ( adjusted incidence risk ratio = 1.56 ; 95 % confidence interval = 1.24–1.93 ; P < 0.0001 ) . Conclusions : SCI is effective in inducing smoking cessation among TB patients . No association of SCI with TB treatment outcomes could be detected BACKGROUND Tobacco use is responsible for a large proportion of the total disease burden from tuberculosis . Pakistan is one of the 10 high-burden countries for both tuberculosis and tobacco use . OBJECTIVE To assess the effectiveness of a behavioral support intervention and bupropion in achieving 6-month continuous abstinence in adult smokers with suspected pulmonary tuberculosis . DESIGN Cluster r and omized , controlled trial . ( Current Controlled Trials : IS RCT N08829879 ) SETTING Health centers in the Jhang and Sargodha districts in Pakistan . PATIENTS 1955 adult smokers with suspected tuberculosis . INTERVENTION Health centers were r and omly assigned to provide 2 brief behavioral support sessions ( BSS ) , BSS plus 7 weeks of bupropion therapy ( BSS+ ) , or usual care . MEASUREMENTS The primary end point was continuous abstinence at 6 months after the quit date and was determined by carbon monoxide levels in patients . Secondary end points were point abstinence at 1 and 6 months . RESULTS Both treatments led to statistically significant relative risks ( RRs ) for abstinence compared with usual care ( RR for BSS+ , 8.2 [ 95 % CI , 3.7 to 18.2 ] ; RR for BSS , 7.4 [ CI , 3.4 to 16.4 ] ) . Equivalence between the treatments could not be established . In the BSS+ group , 275 of 606 patients ( 45.4 % [ CI , 41.4 % to 49.4 % ] ) achieved continuous abstinence compared with 254 of 620 ( 41.0 % [ CI , 37.1 % to 45.0 % ] ) in the BSS group and 52 of 615 ( 8.5 % [ CI , 6.4 % to  
    Output:
    
There is a lack of high- quality evidence , i.e. RCTs , that tests the effectiveness of cessation interventions in improving TB treatment outcomes .