Should interventions to reduce respirable pollutants be linked to tuberculosis control programmes?

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Abstract
Introduction Tuberculosis, smoking, and indoor air pollution from solid fuels are among the leading global causes of death and burden of disease.1 2 Several studies have observed an increased risk of tuberculosis disease or mortality among smokers and those exposed to indoor air pollution, but our understanding of the strength and causal pathways of the risk remains uncertain Tuberculosis and exposure to respirable pollutants are often highest in the poorest socioeconomic groups, who are also those with the least access to interventions and health care. Thus, integrating interventions to reduce smoking and indoor air pollution with tuberculosis control programmes could in principle increase coverage and effectiveness. We discuss the arguments for linking the two public health measures and the scientific uncertainties that currently limit the potential for integration. Acknowledgments We thank Marc Mitchell, Megan Murray, and Joshua Salomon for valuable comments and references. The findings, interpretations, and conclusions expressed here are those of the authors and do not necessarily reflect the views of the board of executive directors of the World Bank or the governments they represent.