Brief advice to tuberculosis patients in Nepal to stop smoking: a pilot study by the Britain Nepal Medical Trust

SETTING

Tuberculosis (TB) treatment centres in Eastern Nepal.

OBJECTIVE

To determine smoking cessation rates among TB patients advised to quit.

DESIGN

One intervention and one control centre were studied. At the intervention centre, brief advice about smoking and cessation was given at the start of anti-tuberculosis treatment, and repeated 2 and 5 months later. After 6 months of standard treatment, patients were asked about quitting. Expired air carbon monoxide (CO) was measured in those claiming 6 months of abstinence.

RESULTS

None of the 51 controls achieved 6 months of abstinence, whereas 77 (39%) of the 195 in the intervention group claimed at least 6 months of abstinence. All claims were verified by CO measurement in expired air (95%CI 31.4-47.6, P < 0.0001 for the difference in smoking cessation).

CONCLUSION

Brief advice on smoking cessation to patients starting anti-tuberculosis treatment in the National Tuberculosis Programme (NTP) setting in Eastern Nepal led to 39% quitting for least 6 months. Our results should encourage randomised trials in smokers with TB in Nepal: if substantiated, smoking cessation advice should become a mandatory component of the NTP.