Smoking increases the risk of contracting tuberculosis (TB), increases the risk of recurrent TB and impairs the response to treatment of the disease. Despite evidence showing these harmful links between tobacco and TB, many Ukrainian patients continue to smoke. But for Vladislav Kirichenko, a former sales manager, a relapse of TB finally convinced him to give up cigarettes.
Vladislav, 36, sits on the edge of an iron hospital bed in the room he shares with 5 other TB patients. His mouth and nose are covered with a paper mask to help prevent the spread of the disease to visitors and hospital staff.
Vladislav contracted TB in 2011, gave up his job and was hospitalized. Doctors warned him about the dangers of smoking, both at the hospital and at the sanatorium where he stayed for a month during the onset of his disease, but it was not until he suffered a relapse that he managed to give up cigarettes. “This time I’ve definitely stopped. I’ve tried before without success, but as soon as I learned that I had fallen ill again, I quit.”
However, not all patients recognize the harmful link between smoking and TB, says Professor Radu Protsenko of the Kiev City TB Dispensary #1, where Vladislav is getting treatment: “One third of my patients smoke. If you want to be cured you have to give up smoking, I tell them, but not all listen.”
Vladislav Kirichenko is one TB patient that Professor Protsenko no longer needs to lecture about smoking. Shaking his head and laughing softly, he says, “I feel the difference now. Before, I used to become short of breath when I climbed 3 flights of stairs, but not anymore. I feel much better since I stopped smoking.”
New evidence confirms harmful links
Links between smoking and TB have long been suspected, but new studies, coupled with reviews of older research, have provided definitive evidence of the connection. In addition to influencing the risk of contracting TB, developing the active form of the disease and ultimately dying from it, smoking is known to negatively influence the response to treatment and to increase the risk of relapse.
Furthermore, recent studies have shown that second-hand smoke increases the risk of contracting the disease, especially in children.
TB in Ukraine
Ukraine first acknowledged that it was facing a TB epidemic in 1995. More than 20 years later, TB continues to present a major public health challenge. Ukraine has the fifth-highest prevalence of multidrug-resistant TB (MDR-TB) in the world, and the country reports relatively high mortality from untreated or inappropriately treated TB. TB/HIV co-infection rates are also on the rise.
Ukraine has been updating its national policies and guidelines in line with the latest WHO recommendations and applying them in daily practice. The country is also moving towards people-centred care, with a correct balance between hospitalization and ambulatory care, by bringing the diagnostics and treatment to the primary health-care level – as close as possible to patients and communities.
Tobacco control in Ukraine
Ukraine ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2006, and since then tobacco control in the country has been strengthened. The results of the Global Adult Tobacco Survey (GATS), released in 2017, show a significant decrease in smoking prevalence in the country over the last 7 years.
In 2017, the Parliament of Ukraine adopted a policy on increasing tobacco taxes for the coming 7 years, until 2024. According to the national plan, in 2018 the specific tobacco tax and minimum excise tax per 1000 cigarettes will increase by 29.7%.
Last year, WHO and partners launched a professional smoking cessation service to support Ukrainians suffering from tobacco dependence. After more than 6 months of testing, the website and quit line will be handed over to the Public Health Center of the Ministry of Health of Ukraine.
