Andersson G, Vala E K, Curvall M
Department of Oral Surgery and Oral Medicine, Lund University, Malmo, Sweden.
J Oral Pathol Med. 1997 Mar;26(3):117-23. doi: 10.1111/j.1600-0714.1997.tb00033.x.
The purpose of this investigation, which has been performed as two studies, was to evaluate the association between the daily exposure to nicotine (measured as cigarette smoking machine yields) and the actual uptake of nicotine by cigarette smokers, as well as the association between oral mucosal changes and the exposure to cigarette smoke. In Study 1, consumption data, soft tissue changes and nicotine intake were measured in 47 habitual smokers using cigarettes with tar and nicotine yields within the ranges 9.3-12.2 and 0.72-1.16 mg per cigarette, respectively. The subjects were divided into three groups based on daily cigarette consumption; group averages (standard deviation) were 10.8 (2.2), 17.9 (1.9) and 28.4 (6.1) cigarettes per day. The group averages of tar deliveries from their usual brands of cigarettes were 11.1, 11.0 and 10.5 mg per cigarette, and group averages of nicotine deliveries were 1.05, 1.05 and 1.06 mg per cigarette, respectively. In Study 2, the same data were measured in a group of 77 habitual smokers with an average individual consumption of 11-21 cigarettes per day. The participants in Study 2 were divided into three groups according to tar delivery from their usual brands to cigarettes, with group averages of tar being 6.4 (1.2), 11.0 (1.2) and 16.0 (1.1) mg per cigarette, and of nicotine being 0.70 (0.12), 1.05 (0.12) and 1.34 (0.08) mg per cigarette, respectively. The average consumption of all three groups was within the range 17.1 to 17.9 cigarettes per day. The daily exposures to nicotine and tar were measured as the smoking machine yields multiplied by the number of cigarettes smoked per day. Nicotine uptake was determined by monitoring nicotine and its seven main metabolites in 24-h urine samples. In Study 1 there were significant differences between the three groups in the total amount of nicotine and metabolites excreted in the 24-h urine. The average nicotine uptake was 14.9, 24.4 and 35.4 mg per day, respectively. In Study 2, the 24-h excretion of nicotine and metabolites was about the same in all three groups and averaged 24.5 mg per day. The nicotine uptake was significantly correlated to the number of cigarettes smoked per day but not to the smoking machine yields of tar and nicotine per cigarette. The average prevalences for each of the different oral mucosal lesions (leukoedema, smoker's palate and hairy tongue) were found to increase with increasing consumption and nicotine uptake (Study 1); they were also independent of tar and nicotine yields from the cigarettes smoked (Study 2). These results indicate that the actual uptake of nicotine by smokers could not be estimated from the smoking machine yields. Reduction in exposure to smoke components may best be accomplished if smokers are encouraged to smoke fewer lower-yield cigarettes and to avoid smoking more of each cigarette.
本研究分两项进行，其目的是评估吸烟者每日尼古丁暴露量（以吸烟机产生量衡量）与实际尼古丁摄入量之间的关联，以及口腔黏膜变化与香烟烟雾暴露之间的关联。在研究1中，对47名习惯性吸烟者进行了消费数据、软组织变化和尼古丁摄入量的测量，他们使用的香烟焦油和尼古丁含量分别在每支9.3 - 12.2毫克和0.72 - 1.16毫克范围内。根据每日香烟消费量将受试者分为三组；每组平均值（标准差）分别为每天10.8（2.2）支、17.9（1.9）支和28.4（6.1）支。他们日常使用品牌香烟的焦油平均释放量分别为每支11.1毫克、11.0毫克和10.5毫克，尼古丁平均释放量分别为每支1.05毫克、1.05毫克和1.06毫克。在研究2中，对一组77名习惯性吸烟者进行了相同数据的测量，他们平均每人每天消费11 - 21支香烟。研究2的参与者根据其日常使用品牌香烟的焦油释放量分为三组，焦油平均含量分别为每支6.4（1.2）毫克、11.0（1.2）毫克和16.0（1.1）毫克，尼古丁平均含量分别为每支0.70（0.12）毫克、1.05（0.12）毫克和1.34（0.08）毫克。三组的平均消费量均在每天17.1至17.9支香烟范围内。每日尼古丁和焦油暴露量通过吸烟机产生量乘以每日吸烟支数来衡量。通过监测24小时尿液样本中的尼古丁及其七种主要代谢物来确定尼古丁摄入量。在研究1中，三组24小时尿液中排泄的尼古丁和代谢物总量存在显著差异。平均尼古丁摄入量分别为每天14.9毫克、24.4毫克和35.4毫克。在研究2中，三组中尼古丁和代谢物的24小时排泄量大致相同，平均为每天24.5毫克。尼古丁摄入量与每日吸烟支数显著相关，但与每支香烟的焦油和尼古丁吸烟机产生量无关。发现不同口腔黏膜病变（黏膜水肿、烟民腭和毛舌）的平均患病率随消费量和尼古丁摄入量的增加而升高（研究1）；它们也与所吸香烟的焦油和尼古丁含量无关（研究2）。这些结果表明，无法根据吸烟机产生量来估计吸烟者实际的尼古丁摄入量。如果鼓励吸烟者少吸低焦油含量香烟并避免每支烟吸得更多，可能最有助于减少烟雾成分的暴露。
