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YES! We can end TB, and curbing tobacco use is a major step

Publish Date:

March 24, 2023

This World Tuberculosis (TB) Day, health organisations forming part of the Protect our Next movement in South Africa are calling for the urgent implementation of a stronger tobacco control policy to create an enabling environment for those who want to quit smoking, a major risk factor for tuberculosis (TB). Smoking increases the risk of contracting TB, increases the risk of recurrent TB and impairs the response to treatment of the disease, says Dr Sharon Nyatsanza, Deputy Director of the National Council Against Smoking.

World TB Day is observed annually on 24 March to raise awareness about TB and efforts to end the global epidemic, marking the day in 1882 when the bacterium causing TB was discovered. The theme of World TB Day 2023 – Yes! We can end TB! – aims to inspire hope and encourage high-level leadership, increased investments, faster uptake of new WHO recommendations, adoption of innovations, accelerated action and multisectoral collaboration to combat the TB epidemic. 

The WHO has called for the integration of tobacco control in country responses to the HIV and TB twin epidemics.  Implementing the WHO Framework Convention on Tobacco Control (WHO FCTC), as the Control of Tobacco and Electronic Delivery Systems Bill seeks to do; will help fight the TB epidemic that South Africa faces.  Partner organisations in the Protect our Next initiative, including the National Council of Smoking (NCAS), the Cancer Association of South Africa (CANSA), the South African Medical Research Council (SAMRC) and the South African Tobacco Free Youth Forum (SATFYF) are hopeful that the Bill, now in parliament,  will be passed in 2023.

In South Africa, 29.4% of people use tobacco, according to the Global Adult Tobacco Survey (GATS-SA) results released last year. “A comprehensive response to the TB epidemic must include a strategy to reduce tobacco use,” says Nyatsanza. “Stronger tobacco control policy will create a more quit-friendly environment, helping more people to stop smoking.”

Dr Nyatsanza provides the following insights on smoking and tuberculosis in South Africa:

  • An estimated 80% of South Africans have TB bacteria, but a strong immune system keeps the bacteria latent and prevents active illness. Tobacco smoke damages the lung’s defence system and impairs our response to viruses and bacteria, making smokers more susceptible to TB infection. Growing evidence shows that the harmful chemicals in e-cigarettes also damage and disable the protective cells of the lungs. This should be reason enough not to start smoking cigarettes, e-cigarettes or hookah pipes, or to stop if you are already a smoker – and to avoid being exposed to second-hand smoke. Hookah pipes also place users at risk of TB transmission if they share a single mouthpiece with someone who already has TB.
  • Quitting is one of the best decisions for health, but this is even more important for tuberculosis (TB) patients. Smoking increases TB risk by more than two-and-a-half times and increases the risk of severe TB. To recover from TB, it’s important to quit smoking and focus on completing your TB treatment. When a person stops smoking, the body’s ability to fight is increased.
  • Smoking while on TB treatment has a negative impact on treatment outcomes, making the medication less effective. It can take longer for the medication to improve the health of the person living with TB. Even after completion of TB treatment, continuing to smoke doubles the chances of developing TB again, which is called recurrent TB. 
  • Secondhand smoke (SHS) is also associated with an increased risk of infection with TB and the development of active TB.  Every smoker with TB should be aware of the harm that their addiction can cause to other individuals, putting others at greater risk of contracting active TB, particularly children.   According to a study published by the National Library of Medicine, children showed a more than thee-fold increased risk of SHS-associated active TB, higher than the risk in adults exposed to SHS.
  • TB remains one of the biggest causes of death in the country. The risk of dying from TB is up to nine times higher for smokers than for never-smokers.  Several studies in South Africa show high smoking rates among TB patients, and this is an urgent concern considering the negative implications smoking has on TB outcomes.

“For South Africa, a country that is disproportionately affected by TB, the passing of the Tobacco Control Bill is urgent. A decrease in tobacco use would improve TB health outcomes and this will also free much-needed funds for TB and other public health priorities,” Nyatsanza concludes.

For help to stop smoking, call the National Council Against Smoking Quitline at 011 720 3145 or send an SMS/WhatsApp message to 072 7664812.



Call the National Council Against Smoking – Quitline at 011 720 3145 for tips to help you stop smoking.  

CANSA runs an online programme which also provides support and information for smokers who would like to stop smoking on

Available for interview:

Sharon Nyatsanza (Phd), Deputy Director, NCAS
Prof. Lekan Ayo-Yusuf, Director of the National Council Against Smoking (NCAS) and the Head of the School of Health Systems and Public Health at the University of Pretoria

Dr Catherine Egbe, Specialist Scientist: Alcohol, Tobacco and other Drug Research Unit, South African Medical Research Council

Sanele Zulu, Convenor: South African Tobacco Free Youth Forum

Zanele Mthembu, Public Health Policy and Development Consultant

Lorraine Govender, National Manager, Health Promotion, CANSA

Media Contact:

Tamaryn Brown

Connect Media for CART agency

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