3.9 Increased susceptibility to infection in smokers

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3.0 Background

3.1 Tobacco—a leading preventable cause of death and disease

3.2 Cardiovascular diseases

3.3 Lung cancer

3.4 Respiratory diseases

3.5 Other cancers caused by or associated with smoking

3.6 Reproductive health and smoking

3.7 Pregnancy and smoking

3.8 Infant health and smoking

3.9 Increased susceptibility to infection in smokers

3.10 Eye diseases

3.11 Dental diseases

3.12 Gastrointestinal diseases

3.13 Bone density and risk of fractures

3.14 Effects of smoking on the skin

3.15 Smoking and complications in medical treatment

3.16 Smoking and diabetes

3.17 Poorer levels of general health

3.18 Smoking, motor vehicle crashes and other injuries

3.19 Burns and fires caused by tobacco use

3.20 Tobacco poisoning

3.21 Health effects for younger smokers

3.22 Genetic influences on tobacco-caused disease

3.23 Smoking, dementia and cognitive decline

3.24 Lung disease, smoking and occupational exposures

3.25 Air pollution, cigarette smoking and ill health

3.26 Health effects of smoking brands that claim to deliver lower levels of tar, nicotine and carbon monoxide

3.27 Health effects of smoking tobacco in other forms

3.28 Health 'benefits' of smoking?

3.29 Morbidity (ill health) attributable to tobacco-caused disease

3.30 Deaths attributable to tobacco by disease category

3.31 Morbidity and mortality due to tobacco-caused disease and socioeconomic disadvantage

3.32 Health effects of smoking other substances

3.33 Health effects of chewing tobacco, and of other smokeless tobacco products

3.34 Public perceptions of tobacco as a drug, and knowledge and beliefs about the health consequences of smoking

3.35 Health benefits of cessation

3.36 The global tobacco pandemic

Acknowledgments

References

Smoking increases the risk of developing infections of the respiratory tract and other systemic infections, and may rival cancer and heart disease as causes of morbidity and mortality due to smoking.59

A recent comprehensive review has found that cigarette smoking poses a substantial risk factor for contracting important bacterial and viral infections, ranging from the common cold through to serious threats to public health such as tuberculosis. It is thought that this is due to the damaging effects of tobacco smoke on the structural defence system within the respiratory tract, and impairment of the immune response both in the lungs and throughout the body.59

Smokers have a two-to-fourfold increased risk of invasive pneumococcal disease, which has a high mortality rate. The risk of catching influenza is several times higher among smokers and they are more likely to experience serious illness. Smokers are also more likely to have legionnaire's disease, meningococcal disease, periodontal disease, and to carry the Helicobacter pylori infection, which is a key factor in developing peptic ulcer disease. Smokers have a higher risk for carrying the human papilloma virus59 (a causal agent in cervical cancer—see Section 3.5.7 above—and probably oropharyngeal cancers as well.[4]60, 61) Smokers are also more likely to be infected with the Human Immunodeficiency Virus (HIV),62 and HIV-positive smokers are more likely than non-smokers to develop a range of other infections.59

Probably of most concern for public health is the finding that smokers are at increased risk of contracting tuberculosis. Current smoking is associated with about a two-fold increase in developing tuberculosis, risk increasing with duration of smoking and amount smoked.59 This has important implications for population groups in which both tuberculosis infection and tobacco use are prevalent. For example, a large case-control study undertaken in India showed that 61% of tuberculosis deaths occurring in men aged between 35 and 69 were attributable to smoking, which was greater than the fraction of smoking attributable deaths from either vascular disease or cancer in this population.63

Passive exposure to tobacco smoke also increases risk of infection among adults and children.59 For more information, refer to Chapter 4, Section 4.10.