The prevalence of smoking was high among TB patients in Malaysia. The results of the present study demonstrate an association between smoking and outcomes of TB. The study further reaffirms that tobacco smoking is a predictor of poor TB treatment outcomes. Therefore, smoking cessation interventions should be offered to all TB patients who are smokers when they are undergoing TB treatment. National TB programs should vigorously integrate tobacco dependence treatment into the management of TB and should provide capacity building for healthcare providers caring for TB patients.