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Additionally, Google Scholar, and Google were used to locate grey literature. Studies were identified through title and abstract screening, followed by a full-text review for eligibility. The Newcastle\u2013Ottawa Scale checklist was employed to assess the quality of included studies. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated for each factor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The initial database search and other sources yielded 10,518 articles. After applying inclusion criteria, 19 studies with a total of 180,119 participants were selected for the meta-analysis. The results revealed significant associations between all three factors and treatment failure. Pooled ORs indicated that alcohol consumption (OR 2.05; 95% CI 1.65 to 2.55), smoking (OR\u2009=\u20091.85; 95% CI 1.44 to 2.37), and substance use (OR 2.04; 95% CI 1.63 to 2.55) were each associated with an increased risk of TB treatment failure. Additionally, the majority of included studies demonstrated high methodological quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that alcohol, smoking, and substance use are significant risk factors for unsuccessful TB treatment. To enhance TB treatment efficacy, preventive interventions aimed at reducing these behaviors before treatment initiation are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13643-025-02888-y","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T10:38:40Z","timestamp":1751711920000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of alcohol consumption, substance use, and smoking on treatment outcomes in tuberculosis: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"14","author":[{"given":"Bahram","family":"Heshmati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanaz","family":"Omidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7521-4909","authenticated-orcid":false,"given":"Younes","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"issue":"2","key":"2888_CR1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.4046\/trd.2015.78.2.47","volume":"78","author":"JY Lee","year":"2015","unstructured":"Lee JY. 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