비흡연자에서 요 중 코티닌 농도를 이용한 간접흡연의 변화: 9개년(2008–2011년, 2014–2018년) 국민건강영양조사를 이용하여 = Trends in Secondhand Smoking and Urine Cotinine Concentration in Non-Smoking Adults in Korea: The 2008–2011, 2014–2018 Korea National Health and Nutrition Examination Survey

국문 초록 (Abstract)

연구배경: 우리나라는 지속적인 금연정책으로 성인 남성 흡연율은감소하고 있다. 직접흡연과 더불어 간접흡연에 의한 위해가 점차 알려지고 금연구역이 확대되면서 직장, 가정, 공공장소에서의 간접흡연 노출이 줄어들고 있는데, 이에 간접흡연의 지표인 요 중 코티닌농도의 변화를 통해서 한국 성인 비흡연자에서 실제 간접흡연 노출정도를 평가하고자 한다.
방법: 본 연구는 국민건강영양조사의 2008년에서 2011년도, 2014년에서 2018년도 자료를 이용하여 요 중 코티닌 조사가 시행된 19세이상의 비흡연자를 대상으로 하여 요 중 코티닌 농도 값을 성별, 연령별, 거주지별, 연도별로 비교하였다.
결과: 한국 성인 비흡연자의 전체 요 중 코티닌 농도 추이는 2011년부터 감소추세로 바뀌어 2010년 2.82 ng/mL에서 2016년 0.50 ng/mL로 점차 감소하였으나 이후 소폭 증가하였으며, 남녀 모두 이와 같은 추이를 보였다. 60대 이상에서 감소경향이 적었으며, 도시보다 농촌 거주자에서 최근 3년간 요 중 코티닌 농도가 더 높아지고 있다.
결론: 비흡연자에서 요 중 코티닌 농도 수치는 2008년부터 2010년까지 증가하다 2011년부터 감소하였으나, 2016년 이후부터 다시 조금씩 증가하였다. 단순 금연구역 확대 정책을 통한 간접흡연 노출 감소의 한계로 보이며, 흡연율을 낮추는 정책 마련과 기존 정책의 엄격한 시행이 필요할 것으로 보인다.

다국어 초록 (Multilingual Abstract)

Background: The risk of secondhand smoke (SHS) is gradually becoming apparent, and as smoking cessation zones are expanding, the exposure to SHSin workplaces, homes, and public places is decreasing. The objective of this study was to evaluate the actual exposure to SHS in nonsmokers.
Methods: This study used data from 2008 to 2011 and 2014 to 2018 from the Korean National Health and Nutrition Examination Survey (KNHANES).
The urine cotinine concentration values were compared by the geometric mean according to sex, age group, and rurality for non-smokers aged 19years or older who were tested for urine cotinine.
Results: The overall trend of urine cotinine concentration in Korean adult non-smokers have shown a decline since 2011. It gradually decreased from2.82 ng/mL in 2010 to 0.50 ng/mL in 2016 but slightly increased to 0.79 ng/mL in 2018. Both male and female showed this trend. The decline tendedto be lower in those aged 60 years and older, with higher urine cotinine concentrations in the recent 3 years in the rural than in urban residents.
Conclusion: The urinary cotinine concentration levels in Korean non-smokers increased from 2008 to 2010, then decreased till 2016, but graduallyincreased thereafter. This is possibly due to limiting the exposure to SHS through expanding the smoking area. Furthermore, a policy to lower thesmoking rate with strict implementation and monitoring of the existing policy will be needed.

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