금연법 만든 국회, 담배연기 자욱

의원들 금연구역서 공공연히 흡연… 사무처 “스스로 법 어겨서야” 단속 강화

동아일보 | 입력 2013.08.27 03:12

매일경제 기사입력 2013.08.16 15:46:47 | 최종수정 2013.08.16 20:31:29 
http://news.mk.co.kr/newsRead.php?sc=30000001&year=2013&no=724804&sID=501

◆ 희비 엇갈리는 담배 vs 술 ◆

지난 7월부터 음식점에서 흡연이 전면 금지되는 등 강력한 금연정책이 시행되고 있지만 담배 매출은 전혀 떨어지지 않은 것으로 나타났다. 16일 세븐일레븐에 따르면 지난 7월 담배 매출은 전월 대비 0.3% 증가했다. 편의점 CU에서도 6월엔 담배 매출이 전월과 비교해 0.9% 떨어졌지만 7월에 다시 0.3% 상승하는 등 금연법 시행 후에 매출이 더 좋은 모습을 보이고 있다.

계속 떨어졌던 연도별 담배 판매도 감소폭이 오히려 둔화되는 추세다. 세븐일레븐의 담배 매출은 2년 연속(2011년 -5.4%, 2012년 -4.3%)으로 전년보다 큰 폭으로 감소했다. 하지만 올해 1~8월 현재 담배 매출은 지난해 동기 대비 2.9% 감소하는 데 그쳤다. 7월의 전년 동기 대비 매출 감소폭은 1.6%로 가장 작다.

정부는 지난 7월 국민건강증진법을 개정하면서 전용면적 150㎡(약 45평) 이상인 음식점, 호프집, PC방 등에서의 흡연을 전면 금지했다. 유통업계는 정부가 금연법을 강력하게 추진하면서 편의점 매출이 급감할 것이라고 예상했다.

[손동우 기자]

Association of Coffee Consumption With All-Cause and Cardiovascular Disease Mortality

Junxiu Liu, MD; Xuemei Sui, MD, PhD; Carl J. Lavie, MD; James R. Hebert, ScD;
Conrad P. Earnest, PhD; Jiajia Zhang, PhD; and Steven N. Blair, PED

Mayo Clin Proc. 2013;nn(n):1-9

연구 논문은 1979~1998년 사이 20~87세, 4만여 명의 미국인 개인 병력 기록을 분석한 것인데… 이 기간 동안 사망한 2만5천여명을 추적 조사한 결과 커피를 많이 마시는 사람은 흡연하는
경우가 많았고… 당연히 폐와 간 상태도 좋지 않았습니다.(이 논문에서는 사망위험의 증가와
흡연과의 연관관계에 대해서 명확하게 분석하지는 않았습니다.)

55세 이하에서 매일 4잔 이상(1주일에 28잔) 이상 커피를 마시는 사람은 사망 위험이 56% 증가하는 것으로 나타났습니다.

남성의 경우 55세 이하에서 커피를 마시는 사람은 그렇지 사망 위험이 21% 증가하는 것으로 나타났습니다.

여성의 경우는 55세 이하에서 커피를 마시는 사람은 그렇지 사망 위험이 2배로 늘어나는 것으로 나타났습니다.

논문에 따르면, 과체중 또는 비만인 경우 커피를 마시는 사람이 많았지만, 이것이 사망위험의 증가에 큰 영향을 끼친 것으로 보이지는 않은 것으로 판단한 것 같습니다.

이 논문은 역학 조사를 한 결과이기 때문에 커피의 어떤 성분 때문에 55세 이하 연령층에서
사망 위험이 높게 나타나고… 그 이상의 노령층에서는 역학적 연관관계가 없었는지에 대해서
명확하게 규명하지 못했으며… 커피 속에 들어 있는 어떤 성분 때문에 사망 위험이 높아졌는
지에 대해서도 명확하게 규명하지 못했습니다.

논문의 공동저자 중 한 명인 쉬메이 수이는 언론 인터뷰에서 “커피에는 카페인이 들어 있는데, 카페인은 부신 피질 호르몬 분비를 촉진하고 인슐린 활동을 방해하며 혈압을 상승시킨다”고 주장하며, “많은 양의 커피를 마시는 사람들은 밤 늦게 잠이 들고 식사를 빈약하게 하는 생활습관이 있는 편”이라고 했습니다.

논문의 저자들은 이 논문의 한계에 대해서도 밝혀놓았습니다. 첫째, 연구 기간 동안 커피의 소비량에 대해 반복적으로 측정하지 않은 점, 둘째, 커피를 내리는 방법에 따라 커피의 구성성분이 달라지고 이에 따라 사망률의 차이가 발생할 수 있으나 이 논문에서는 그러한 데이터를 제시하지 못한 점, 셋째, 본 연구에서는 결혼 여부와 전체 에너지 소비를 포함시키지 않은 점, 넷째, 종속변수에 영향을 줄 수 있는 독립변수 이외의 변수인 confounding이 존재할 가능성이 있는 점.(저자들은 자신들이 비록 보정을 했지만, 담배 같은 변수가 사망위험에 영향을 끼칠 confounding이 될 수 있다는 점을 고려했지만, 저자들은 현재 흡연자와 비흡연자 간의 커피 소비와 모든 원인의 치명률 사이의 어떠한 중요한 연관관계도 찾아내지 못했다고 밝힘)

(참고 : 옮긴이 주 – 통계적으로 커피를 많이 마시는 사람은 췌장암에 많이 걸리는 것으로 나오지만… 사실은 커피를 많이 마시는 사람은 담배도 함께 피우기 때문에 췌장암에 걸리는 것입니다. 따라서 커피와 췌장암의 연관성은 흡연에 의한 confounding때문에 나타난 것입니다.)

마지막으로 저자들은 자신의 논문의 한계로 세대효과(cohort effect)가 존재할 수 있다고 밝혔습니다.

(참고 : 옮긴이 주 – 세대 효과(cohort effect)의 예로 한국과 미국의 유방암 발생의 차이를 설명하기도 합니다. 미국은 폐경 후 유방암에 걸리는 여성들이 훨씬 많은데, 한국은 오히려 폐경 전 유방암에 걸리는 여성들이 훨씬 많습니다. 경제적-사회적-문화적인 변화에 의해 한국 여성들의 라이프 스타일의 변화가 유방암 발생의 차이를 불러왔다는 것입니다. 한국 여성들의 결혼이 늦어지면서 유방암 예방 효과가 있는 출산과 수유를 기피하는 현상이 생겼으며, 유방암을 일으킬 수 있는 술이나 담배에 노출된 여성들이 증가한 것이 한국 여성들의 폐경전 유방암 환자 비율을 증가시킨 세대 효과(cohort effect)라고 분석하고 있습니다. 물론 이러한 분석이 과학적으로 정당한 것인가는 증명이 된 것은 아닙니다.)

Study: Heavy coffee drinking in people under 55 linked to early death

흡연자의 가족들은 위암, 폐암 등에 걸릴 위험이 더 높아지는데… 이는 담배연기 속의 유해성분이 베인 옷이나 카펫트, 벽지 등에서 2개월 동안 잔류해 있으면서 실내 공기 중에 존재하는 아질산(the common indoor air pollutant nitrous acid)과 섞여서 니트로스아민을 형성하기 때문으로 밝혀졌습니다.(니트로스아민은 담배에 있는 유해성분은 아닙니다. 흡연 후 2차적 또는 3차적으로 실내 공기에서 형성되는 발암물질입니다)

Study reveals dangers of nicotine in third-hand smoke

Lawrence Berkeley National Laboratory scientists Lara Gundel and Michael Apte contributed to the study, which was led by Ruiling Liu and Katharine Hammond from UC Berkeley’s School of Public Health. The results were published in the journal Tobacco Control in a paper titled, “Assessment of risk for asthma initiation and cancer and heart disease deaths among patrons and servers due to secondhand smoke exposure in restaurants and bars.”

Taking exposure data from 65 restaurants and bars in Minnesota over an eight-month period in 2007, the researchers found that the lifetime excess risk of lung cancer death was 18 in a million for patrons visiting only nonsmoking sections and 80 in a million for patrons in the smoking section. For servers, the lifetime excess risk was 802 in a million for lung cancer death.

Extrapolating to the entire country, the researchers estimate that the lifetime excess risk for the general nonsmoking population due to exposure to secondhand smoke in restaurants and bars would result in 214 additional lung cancer deaths and 3,001 additional heart disease deaths per year.

“One in a million is significant,” said Gundel. “You can’t control people smoking, but to support tobacco-free policies we need to know how to protect people.”

Although smoking bans have been enacted in many parts of the country, one quarter of the U.S. population remains unprotected by smoke-free policies in restaurants and 35 percent in bars, according to the study. Globally 95 percent of the population is unprotected by smoke-free policies in restaurants and bars. Moreover tobacco companies continue to fight smoking bans, and increasing numbers of cities are repealing or weakening them.

While previous studies have examined health risks for people working in restaurants and bars, none had quantified risks to patrons. In the U.S. 66 percent of adults eat out at least weekly, and for nonsmokers restaurants and bars may be their predominant source of secondhand smoke exposure. The researchers assumed weekly visits to restaurants for 60 years.

This was also the first study to look at servers’ risk of asthma initiation due to secondhand smoke exposure. They estimated the risks to correspond to 1,420 new asthma cases per year among nonsmoking servers in the United States.

“There are huge economic impacts related to smoking,” Gundel said. “It’s worth it to society to try to minimize the damage from smoking.”

====================

Secondhand Smoke in Bars and Restaurants Means Higher Risk of Asthma and Cancer

Julie Chao (510) 486-6491  JHChao@lbl.gov

Nicotine in third-hand smoke, the residue from tobacco smoke that clings to virtually all surfaces long after a cigarette has been extinguished, reacts with the common indoor air pollutant nitrous acid to produce dangerous carcinogens. This new potential health hazard was revealed in a multi-institutional study led by researchers with the Lawrence Berkeley National Laboratory (Berkeley Lab).

In tests at Berkeley Lab of cellulose surfaces contaminated with nicotine residues from third-hand smoke, levels of newly formed TSNAs rose 10 times following a three hour exposure to nitrous acid. TSNAs are potent carcinogens. (Photo by Roy Kaltschmidt, Berkeley Lab Public Affairs)

“The burning of tobacco releases nicotine in the form of a vapor that adsorbs strongly onto indoor surfaces, such as walls, floors, carpeting, drapes and furniture. Nicotine can persist on those materials for days, weeks and even months. Our study shows that when this residual nicotine reacts with ambient nitrous acid it forms carcinogenic tobacco-specific nitrosamines or TSNAs,” says Hugo Destaillats, a chemist with the Indoor Environment Department ofBerkeley Lab’s Environmental Energy Technologies Division. “TSNAs are among the most broadly acting and potent carcinogens present in unburned tobacco and tobacco smoke.”

Destaillats is the corresponding author of a paper published in the Proceedings of the National Academy of Sciences (PNAS) titled “Formation of carcinogens indoors by surface-mediated reactions of nicotine with nitrous acid, leading to potential third-hand smoke hazards.”

Co-authoring the PNAS paper with Destaillats were Mohamad Sleiman, Lara Gundel and Brett Singer, all with Berkeley Lab’s Indoor Environment Department, plus James Pankow with Portland State University, and Peyton Jacob with the University of California, San Francisco.

The authors report that in laboratory tests using cellulose as a model indoor material exposed to smoke, levels of newly formed TSNAs detected on cellulose surfaces were 10 times higher than those originally present in the sample following exposure for three hours to a “high but reasonable” concentration of nitrous acid (60 parts per billion by volume). Unvented gas appliances are the main source of nitrous acid indoors. Since most vehicle engines emit some nitrous acid that can infiltrate the passenger compartments, tests were also conducted on surfaces inside the truck of a heavy smoker, including the surface of a stainless steel glove compartment. These measurements also showed substantial levels of TSNAs. In both cases, one of the major products found was a TSNA that is absent in freshly emitted tobacco smoke – the nitrosamine known as NNA. The potent carcinogens NNN and NNK were also formed in this reaction.

“Time-course measurements revealed fast TSNA formation, up to 0.4 percent conversion of nicotine within the first hour,” says lead author Sleiman. “Given the rapid sorption and persistence of high levels of nicotine on indoor surfaces, including clothing and human skin, our findings indicate that third-hand smoke represents an unappreciated health hazard through dermal exposure, dust inhalation and ingestion.”

Since the most likely human exposure to these TSNAs is through either inhalation of dust or the contact of skin with carpet or clothes, third-hand smoke would seem to pose the greatest hazard to infants and toddlers. The study’s findings indicate that opening a window or deploying a fan to ventilate the room while a cigarette burns does not eliminate the hazard of third-hand smoke. Smoking outdoors is not much of an improvement, as co-author Gundel explains.

Berkeley Lab chemists Lara Gundel and Hugo Destaillats led a research team that revealed the potential health hazards posed by residual nicotine in third-hand smoke when it reacts with ambient nitrous acid. (Photo by Roy Kaltschmidt, Berkeley Lab Public Affairs)

“Smoking outside is better than smoking indoors but nicotine residues will stick to a smoker’s skin and clothing,” she says. “Those residues follow a smoker back inside and get spread everywhere. The biggest risk is to young children. Dermal uptake of the nicotine through a child’s skin is likely to occur when the smoker returns and if nitrous acid is in the air, which it usually is, then TSNAs will be formed.”

The dangers of mainstream and secondhand tobacco smoke have been well documented as a cause of cancer, cardiovascular disease and stroke, pulmonary disease and birth defects. Only recently, however, has the general public been made aware of the threats posed by third-hand smoke. The term was coined in a study that appeared in the January 2009 edition of the journal “Pediatrics,” in which it was reported that only 65 percent of non-smokers and 43 percent of smokers surveyed agreed with the statement that “Breathing air in a room today where people smoked yesterday can harm the health of infants and children.”

Anyone who has entered a confined space – a room, an elevator, a vehicle, etc. – where someone recently smoked, knows that the scent lingers for an extended period of time. Scientists have been aware for several years that tobacco smoke is adsorbed on surfaces where semi-volatile and non-volatile chemical constituents can undergo reactions, but reactions of residual smoke constituents with atmospheric molecules such as nitrous acid have been overlooked as a source of harmful pollutants. This is the first study to quantify the reactions of third-hand smoke with nitrous acid, according to the authors.

Mohamad Sleiman was the lead author of a paper titled “Formation of carcinogens indoors by surface-mediated reactions of nicotine with nitrous acid, leading to potential third-hand smoke hazards.” (Photo by Roy Kaltschmidt,Berkeley Lab Public Affairs)

“Whereas the sidestream smoke of one cigarette contains at least 100 nanograms equivalent total TSNAs, our results indicate that several hundred nanograms per square meter of nitrosamines may be formed on indoor surfaces in the presence of nitrous acid,” says lead-author Sleiman.

Co-author James Pankow points out that the results of this study should raise concerns about the purported safety of electronic cigarettes. Also known as “e-cigarettes,” electronic cigarettes claim to provide the “smoking experience,” but without the risks of cancer. A battery-powered vaporizer inside the tube of a plastic cigarette turns a solution of nicotine into a smoky mist that can be inhaled and exhaled like tobacco smoke. Since no flame is required to ignite the e-cigarette and there is no tobacco or combustion, e-cigarettes are not restricted by anti-smoking laws.

“Nicotine, the addictive substance in tobacco smoke, has until now been considered to be non-toxic in the strictest sense of the term,” says Kamlesh Asotra of the University of California’s Tobacco-Related Disease Research Program, which funded this study. “What we see in this study is that the reactions of residual nicotine with nitrous acid at surface interfaces are a potential cancer hazard, and these results may be just the tip of the iceberg.”

The Berkeley Lab researchers are now investigating the long-term stability in an indoor environment of the TSNAs produced as a result of third-hand smoke interactions with nitrous acid. The authors are also looking into the development of biomarkers to track exposures to these TSNAs. In addition, they are conducting studies to gain a better understanding of the chemistry behind the formation of these TSNAs and to find out more about other chemicals that are being produced when third-hand smoke reacts with nitrous acid.

“We know that these residual levels of nicotine may build up over time after several smoking cycles, and we know that through the process of aging, third-hand smoke can become more toxic over time,” says Destaillats. “Our work highlights the importance of third-hand smoke reactions at indoor interfaces, particularly the production of nitrosamines with potential health impacts.”

In the PNAS paper, Destaillats and his co-authors suggest various ways to limit the impact of the third hand smoke health hazard, starting with the implementation of 100 percent smoke-free environments in public places and self-restrictions in residences and automobiles. In buildings where substantial smoking has occurred, replacing nicotine-laden furnishings, carpets and wallboard might significantly reduce exposures.

Berkeley Lab is a U.S. Department of Energy national laboratory located in Berkeley, California.  It conducts unclassified scientific research for DOE’s Office of Science and is managed by the University of California. Visit our Website at www.lbl.gov/

Additional Information

For more information about Berkeley Lab’s Indoor Environment Department and its researchers visit the Website at http://eetd.lbl.gov/r-indoor.html

For more information on the research of James Pankow visit the Website athttp://www.pdx.edu/chem/profile/dr-james-f-pankow

For more information on the research of Peyton Jacob visit the Website athttp://cancer.ucsf.edu/people/jacob_peyton.php

For more information on the University of California’s Tobacco-Related Disease Research Program (TRDRP) visit the Website at http://www.trdrp.org

For a list of health experts who may be able to provide comments and quotes, contact Kamlesh Asotra at kamlesh.asotra@ucop.edu or 510-287-3366.

===============

[참고]

로렌스-버클리 연구소의 성장

http://www.postech.ac.kr/press/hs/C30/C30S001.html

지금의 로렌스 버클리 연구소(야경) 초기 방사연구소 건물 앞의 로렌스 초기 방사 연구소

‘부동산 비리의혹’ KT&G 민영진 사장 등 8명 출금(종합)

술·담배 규제강화 사실상 올스톱..방치된 국민건강

연합뉴스 2013/06/03 06:49
http://www.yonhapnews.co.kr/society/2013/06/01/0706000000AKR20130601052600017.HTML

Justices decline to hear challenge to tobacco law

By Lawrence Hurley

WASHINGTON (Reuters) – The U.S. Supreme Court on Monday declined to hear a tobacco industry challenge to a federal law that expanded restrictions on the advertising and marketing of cigarettes.

The provisions of the 2009 Family Smoking Prevention and Tobacco Control Act under attack included one requiring the display of a large health warning on packaging and another banning the sponsorship of public events.

The law also requires that before a tobacco product can be marketed, the manufacturer must prove to the U.S. Food and Drug Administration that it is less dangerous than other tobacco products. This provision is aimed at descriptive marketing terms such as “light” and “mild.”

Those challenging the provisions of the law included companies owned in part or in full by Reynolds American Inc, British American Tobacco Plc, Imperial Tobacco Group Plc and Lorillard Inc.

The companies claimed the law violates the First Amendment’s guarantee of freedom of speech, imposing “myriad restrictions on truthful, non-misleading speech to adult tobacco consumers.”

In response, the Obama administration noted in court papers that the law was specifically drafted to battle a recognized public health problem. Congress was particularly interested in restricting the marketing of cigarettes to young people, government lawyers wrote.

The Cincinnati-based 6th U.S. Circuit Court of Appeals upheld the law in full, saying the warnings “are reasonably related to the government’s interest in preventing consumer deception.”

The case is distinct from a separate industry challenge to regulations the FDA issued to implement the graphic warning requirement. The U.S. Court of Appeals for the District of Columbia Circuit tossed out the regulation. The FDA is currently drafting a new one.

The case is American Snuff Company v. United States, U.S. Supreme Court, No. 12-521.

(Reporting by Lawrence Hurley; Editing by Howard Goller, Gerald E. McCormick and John Wallace)

<"흡연경고그림, 캐나다·브라질 흡연율 낮췄다">

“고3부터 85세까지 남성 22%는 담배로 사망 추정”