Abstract
Tuberculosis (TB) remains a significant global health issue, particularly in countries like Kazakhstan, which is among the 30 high TB burden nations. Tobacco smoking is a major risk factor that increases susceptibility to TB infection and worsens treatment outcomes by impairing immune defenses. Aim: This study aimed to assess the prevalence of active tobacco smoking among TB patients in Kazakhstan and to evaluate how smoking affects TB treatment outcomes. Additionally, it sought to understand patients’ perceptions regarding smoking during treatment. Method: A cross-sectional observational study was conducted in several hospitals in Almaty involving 105 adult TB patients in 2025. Data on smoking status, demographics, and treatment outcomes were collected using structured questionnaires and medical records, with statistical analysis performed to examine associations. Results: Among the patients, 31.5% were active smokers who showed significantly worse treatment outcomes than non-smokers, including higher rates of treatment failure and abandonment. Logistic regression revealed that smokers had nearly three times higher odds of unsuccessful treatment (OR=2.82, p=0.015). Discussion: The findings align with global evidence linking smoking to poor TB outcomes and highlight that psychological factors, such as stress relief from smoking, contribute to continued tobacco use among TB patients. These results underscore the need for integrated smoking cessation and mental health support within TB care programs. Conclusion: Tobacco smoking is common among TB patients in Kazakhstan and is associated with poorer treatment success. Implementing routine tobacco use screening and cessation interventions alongside psychological support is essential to improve TB treatment outcomes