담배의 표기된 니코틴 함량과 요코티닌 수치의 관계
Relationship between Brand Nicotine Yield of Cigarettes and Urine Cotinine Level in Male Smokers
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연구배경: 담배의 위험을 감소시키는 전략의 하나로 니코틴 함량이 낮은 담배를 다수의 담배 회사가 개발, 출시하고 있다. 일부의 대중들은 저니코틴, 저타르 함유 담배가 일반 담배보 다 건강 상의 해악이 적을 것으로 인식하고 있으며, 흡연 인구 중 상당 수가 건강 상 이유로 니코틴과 타르의 함량이 적은 담 배를 선호하고 있다. 이에 본 연구에서는 니코틴 함량이 낮은 담배를 피울 경우 일반 담배를 피울 경우보다 니코틴 흡수량 이 적은 지를 요 코티닌 측정을 통해 알아보고자 하였다. 방법: 2007년 5월부터 6개월간 일개 종합 병원에서 건강 검진 을 받는 18세 이상의 특별한 질환이 없는 남성 흡연자 464명을 대상으로 현재 흡연 중인 담배의 니코틴 함량 및 흡연력에 대 해 설문하였고, 요 코티닌을 측정하였다. 니코틴 함량에 따라 초저니코틴 담배군(니코틴 0.05 ㎎), 저니코틴 담배군(니코 틴 0.1 ㎎) 및 일반 담배군(니코틴 0.1 ㎎ 초과)으로 연구대상 자를 구분하여 분석하였다. 결과: 요 코티닌 농도의 중앙값은 초저니코틴 담배군, 저니코 틴 담배군, 일반 담배군에서 735.5 ng/㎖ (사분위 범위, 320- 1,300 ng/㎖), 956.0 ng/㎖ (429-1,491 ng/㎖), 1,067.5 ng/㎖ (615-1,613 ng/㎖)였으며, 통계적으로 유의한 차이가 있었 다 (P=0.015). 그러나 요 코티닌 상승(4분위수 이상, ≥ 1,532 ng/ ㎖) 위험에 대한 단순 로지스틱 회귀분석을 시행한 결과 일 반 담배군을 기준으로 저니코틴 담배군의 교차비는 0.82 (95% CI, 0.52-1.28), 초저니코틴 담배군의 교차비는 0.77 (95% CI, 0.39-1.51) 로 통계적 유의성은 없었다. 교란 변수를 보정하 고 시행한 다중 로지스틱 회귀분석의 결과 또한 일반 담배군 을 기준으로 저니코틴 담배군의 교차비는 0.84 (95% CI, 0.52- 1.37), 초저니코틴 담배군의 교차비는 0.82 (95% CI, 0.38-1.72) 로 통계적으로 유의하지 않았다. 결론: 성인 남성에서 담배의 니코틴 함량에 따른 요 코티닌 상 승의 위험도는 유의한 차이가 없었다.
Abstract
Background: As one of harm reduction strategies, tobacco manufacturers have begun to introduce lower-yield cigarettes. Lower-yield cigarettes, so called light cigarettes, have been perceived as less hazardous by some smokers. However, there have been very few studies concerning smoking lower yield products the lead to lower nicotine absorption. We evaluated the association between brand nicotine yield of cigarettes and actual nicotine intake by measuring urinary cotinine. Methods: Four hundred sixty four male smokers aged 18 or over who participated in health check-ups in a hospital from May to October 2007 fi lled out a self-administered smoking questionnaire. Urinary cotinine concentration was measured at the time of participation. The subjects were divided into three groups (ultralight [nicotine: 0.05 ㎎], light [0.1 ㎎], and regular [> 0.1 ㎎] group) according to the level of brand nicotine yield of cigarettes which they smoked. Results: The median urinary cotinine concentrations of ultralight (N = 62), light (N = 216), and regular (N = 186) groups were 735.5 ng/㎖ (interquartile range, 320 to 1,300 ng/㎖), 956.0 ng/㎖ (429 to 1,491 ng/㎖), and 1,067.5 ng/㎖ (615 to 1,613 ng/㎖), respectively. There was a signifi cant difference in urinary cotinine between the regular and the other groups (P = 0.015). However, multiple logistic regression analysis to evaluate the risk of being in the highest quartile of urinary cotinine concentration (≥ 1,532 ng/㎖) after adjusting for possible confounding variables showed that the odds ratios were 0.84 (95% CI, 0.52 to 1.37) in the light nicotine group and 0.82 (95% CI, 0.38 to1.72) in the ultralight nicotine group compared to the regular nicotine group. Conclusion: There was no significant difference in the risk of elevated urinary cotinine concentrations in male adult smokers according to brand nicotine yield of cigarettes groups.
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