Smoking, active or passive, is an important risk factor for the development of tuberculosis (TB), influencing stages from latent infection to active disease. In addition, tobacco use is associated with poorer treatment response, increased recurrence, and higher mortality. In this context, it is relevant to understand this relationship in regions with high disease burden, such as Northeast Brazil. This study aims to analyze the association between TB and smoking in Northeast Brazil from 2020 to 2024. Ecological, quantitative, and descriptive study using data extracted from the Notifiable Diseases Information System (SINAN), available in the DATASUS database. All confirmed TB cases in the Northeast between 2020 and 2024 were included, with emphasis on the smoking variable reported in notifications. In the analyzed period, 128,811 TB cases were recorded in the Northeast, of which 29,048 (22.55%) were associated with smoking. In 2020, there were 22,313 TB cases, with 4,365 (19.56%) smokers. In 2021, cases increased to 23,830, with 4,957 (20.80%) associated with tobacco, representing a 13.56% increase compared to the previous year. In 2022, 27,206 TB cases and 6,232 (22.91%) smokers were observed, an increase of 25.72%. In 2023, 27,903 cases were recorded, of which 6,721 (24.09%) had a history of smoking, corresponding to a 7.85% growth. Finally, in 2024, there were 27,559 new cases, with 6,773 (24.57%) associated with tobacco, representing a 0.77% increase compared to 2023. A rising trend is noted both in total cases and in the proportion associated with smoking over the years, with percentages increasing gradually. This study highlights the relevant association between smoking and TB cases in Northeast Brazil from 2020 to 2024. Over these years, a progressive increase in the proportion of tobacco-related cases is observed. In this scenario, it is essential to implement integrated public policies that link tobacco control actions with TB prevention and control strategies. Such measures should prioritize health promotion, early diagnosis, and treatment adherence, in order to reduce both morbidity and disease burden in the region.
Salles et al. (Sun,) studied this question.