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If the world’s population continues to smoke at current levels, smoking could lead to an extra 18 million cases of tuberculosis (TB), and 40 million excess deaths by 2050, a new study concludes. Aggressive tobacco control could avoid millions of deaths from tuberculosis, the researchers write in the British Medical Journal.

Researchers looked at different scenarios of smoking rates and built mathematical models for each one, the Los Angeles Times reports. Currently, about 20 percent of the world’s population smokes. The researchers projected that if smoking rates grow until half of people smoke, there would be an extra 34 million TB cases due to smoking, and 114 million excess deaths from smoking-related TB by 2050.

Doctors believe smoking may make a person more susceptible to TB by decreasing the lungs’ ability to fight infections, the article notes.

“The tobacco industry has spent decades working to convince developing countries as well as funding agencies that they should not ‘waste’ their time on tobacco control, but rather focus on infectious diseases like tuberculosis at the same time that the multinational tobacco companies were expanding aggressively in those very countries,” lead author Dr. Sanjay Basu of the University of California, San Francisco said in a news release.

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