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研究生:林宏茂
研究生(外文):Hong-Mao Lin
論文名稱:抽濃淡菸者尿中可丁尼濃度及呼吸系統健康效應之比較
論文名稱(外文):Comparison with urinary cotinine levels and respiratory health effects between light and heavy smokers
指導教授:陳叡瑜陳叡瑜引用關係
指導教授(外文):Ruey-Yu Chen
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:公共衛生學系
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
論文頁數:75
中文關鍵詞:尼古丁可丁尼濃菸淡菸
外文關鍵詞:NicotineCotinineLow-yield nicotine cigaretteregular cigarette
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近幾年來由於菸商的強力促銷,淡菸已漸漸成為菸品市場中的主流商品,且吸菸者多相信吸淡菸的危害要比吸濃菸小得多,然而是否真的如此呢?
本研究目的主要探討國人吸菸者尿中可丁尼的濃度及呼吸系統健康效應與所使用菸品尼古丁濃度的關係。我們共收集133位自願受試者為研究對象,每位受試者需填寫結構式問卷,以獲得吸菸者的吸菸習慣(菸品種類、每日吸菸量及吸菸年數等)和呼吸道健康現況資料及尼古丁依賴性,並於問卷施測後進行肺功能和呼出CO氣體測定,每位受測者均提供尿液以檢測尼古丁代謝產物-可丁尼濃度。
研究結果顯示,尼古丁依賴性與每日吸菸支數對尿中可丁尼濃度的影響最大,而與所使用的菸品濃度並無相關;吸菸者呼吸道症狀明顯多於非吸菸者,但吸淡菸者的呼吸道症狀並未少於吸濃菸者。由於尼古丁依賴性與尿中可丁尼濃度的高度相關,故尼古丁依賴性量表應可作為一個良好的香菸危害暴露指標。
  本篇研究結果強烈暗示淡菸使用者的菸品暴露危害,菸害防制相關單位應重視。
It is well known that smoking harms nearly every organ of the body, causing many diseases and reducing quality of life and life expectancy. Recent years, low-yield nicotine cigarettes become more popular than regular cigarettes because of the market promotion by tobacco industries. And moreover, many people believe that low-yield nicotine cigarettes are less hazardous than regular cigarettes. Is it really true that low-yield nicotine cigarettes are less hazardous?
The aim of this study is to identify the difference of urinary cotinine levels and prevalence of respiratory symptoms between low and high-yield nicotine cigarettes smokers.We collect 133 Taiwanese male adult subjects and divide to 4 groups according to their brand nicotine yield. Each subject filled out a self-administered questionnaire. Urinary cotinine concentrations, pulmonary function test and expired CO concentrations were also measured for every participant.
  The result shows that nicotine dependence significantly increased urinary cotinine concentration regardless of the nicotine yield of brands. Significant differences in prevalence of respiratory symptoms were observed among smokers vs nonsmokers, but it can not find between low-yield nicotine smokers and regular cigarettes smokers. The Fagerström Test for Nicotine Dependence were highly correlated with urinary cotinine concentrations. It would be a good indicator of smoking hazardous exposure.
There are no significant differences of cotinine levels and respiratory symptoms were found between low-yield nicotine smokers and regular cigarettes smokers. We suggest the authorities of smoking control should strengthen the education for low-yield nicotine smokers.
表目錄 III
圖目錄 IV
第一章 前言 1
研究假設 2
研究目的 2
研究架構 3
第二章 文獻探討 4
第一節 國內外的吸菸情形 4
第二節 香菸的危害 5
第三節 菸品暴露的生物指標 6
第四節 使用菸品的尼古丁濃度與體內古丁尼濃度的關係 7
第五節 菸品成份 9
第三章 材料與方法 11
第一節 研究對象 11
第二節 問卷設計 11
第三節 問卷頻率選項之量化轉換 13
第四節 肺功能測量 15
第五節 呼氣CO濃度的測量 16
第六節 以GC-FID分析尿中COTININE濃度 16
第七節 統計分析 21
第四章 結果 22
第一節 研究樣本基本資料 22
第二節 濃淡菸使用者吸菸習慣與尼古丁依賴情形之比較 22
第三節 尿中可丁尼濃度及其影響因子 24
第四節 健康效應 26
第五節 呼吸道症狀及其影響因子 27
第五章 討論 43
第一節 尿中可丁尼濃度及其影響因子討論 43
第二節 健康效應討論 45
第三節 菸害防制應重視淡菸之影響 46
第四節 研究限制 46
第六章 結論與建議 47
第七章 參考文獻 48
附錄一 可丁尼檢量線 55
附錄二 尿液可丁尼的層析圖-BLANK 56
附錄三 尿液可丁尼的層析圖-Methanol 57
附錄四 尿液可丁尼的層析圖-可丁尼(10 μg/ml)於Methanol中 58
附錄五 尿液可丁尼的層析圖-非吸菸者 59
附錄六 尿液可丁尼的層析圖-吸菸者 60
附錄七 問卷 61
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