Our analyses identified two plausible pathways between heavy alcohol consumption and TB. First, heavy alcohol consumption affects the immune system, thus facilitating susceptibility to infection as well as conversion to active TB in infected individuals [36-38]. Second, alcohol use may lead to being in social environments which facilitate the spread of TB infection [39]. Other common cause factors (e.g., poverty) may impact the association, but this does not invalidate the conclusion that alcohol is one component in a sufficient component causal mechanism for incidence of TB [39].
