Background:
Evidences have highlighted significant association between smoking and tuberculosis (TB). Smokers tend to delay accessing health services, more likely to have poor treatment outcome, and higher risk of recurrent TB than non-smokers. To address dual burden of TB and smoking, the Union published a guideline on smoking cessation intervention for TB patients, and piloted it in China. By the end of anti-TB treatment, 66.6% of current smokers quitted smoking, but we do not know the long-term outcome. We therefore conducted a follow up study to assess long-term outcome of the intervention project.

Methods:
This is a longitudinal study. The cohort was established during the pilot in Xingguo and Ningdu County of Jiangxi Province, China in 2010-2011. Follow up visits were performed by village doctors after 5-year completion of the pilot and their anti-TB treatments.

Results:
800 TB patients were registered, including 572 male and 228 female. Of them, 271 smear positive, 507 smear negative and 22 extra-pulmonary TB. Of the 800 patients at baseline, 433 were non-smoker, 100 were Ex-smoker, 23 were recent quitter, 244 were current smoker (233 were on cessation intervention program). After 5-year, percentage of remained non-smoking was highest in the group of non-smoker at baseline, but was lowest in the current smoker without cessation intervention program (Table 1, P<0.001). Age 45-64 years (P=0.005) and ≥65 years (P=0.009) at baseline are independently confirmed risk factors for remained smoking or back to smoking.

Conclusions:
Percentage of remained non-smoking in the intervention group after 5-year was higher than those without intervention indicates good effect and need of integration of brief advice into routine TB service. Special attention should be given to those of 45-64 years and those of ≥65 years. 3.9% of non-smoker at baseline become smoker indicates the need of continuing health education after TB treatment.
Table 1: Smoking status of the TB patients after 5-year, stratified by their baseline smoking status

	Non-smoker	X-smoker	Recent quitter	Current smoker on cessation program	Current smoker not on cessation program
Total at baseline	433	100	23	234	10
No (%) of remained non-smoking after 5-year	355 (82.0)	63 (63.0)	10 (43.5)	116 (49.6)	3 (30.0)
No (%) of continuing or back to smoking after 5-year	17 (3.9)	13 (13.0)	4 (17.4)	63 (26.9)	6 (60.0)
X2	104.239
P value	<0.001