二手烟对健康的危害

二手烟雾对二手烟雾对健康的健康的危害危害

• 二手烟雾，又称非自愿吸烟、环境烟草烟雾或者被动吸烟，是一种由4000多种化合物组成的复杂混合

物，其中包括69种已知的致癌物1。这些化合物以微粒和气体的形式释放到空气中。烟草烟雾的微粒部分包含尼古丁、“焦油”(其本身又由很多化合物组成)、苯和苯并芘。气体部分包括一氧化碳、氨、二甲基亚硝胺、甲醛、氢氰酸和丙烯醛2。

• 接触二手烟雾带来健康风险，对此有大量明确而令人信服的科学依据予以证实。二手烟雾是已知的导

致肺癌、心脏病、低出生体重以及支气管炎和哮喘（尤其在少年儿童中）等慢性肺部疾病的主要原因。

• 这些科学证据得出有力的结论：二手烟雾不存在安全暴露水平。

二手烟雾引起死亡、二手烟雾引起死亡、疾病和残疾疾病和残疾

• 《烟草控制框架公约》（FCTC）第8条第1款指出：“科学已明确证实接触烟草烟雾会造成死亡、疾

病和功能丧失3。”

• 在2002年的一份报告中，世界卫生组织的国际癌症研究署（IARC）得出结论，二手烟雾会引起肺癌、

心脏病和其它健康问题4。

• 美国卫生署长在2006年6月发布的《非自愿接触烟草烟雾的健康后果》报告中确认，二手烟雾会引起癌

症、心脏病和严重的肺部疾病。就象前卫生署长Richard Carmona在发布报告时指出的：“辩论已经结束。科学证据和结论也很明确，二手烟雾不只让人讨厌，而且是一种严重的健康危害5。”

• 2005年1月，美国公共卫生服务局的国家毒理学项目发布了第11份《致癌物报告》。报告明确指

出：

“许多研究证明被动烟草烟雾接触与肺癌之间存在因果关系，提供了环境烟草烟雾致癌性的充分证据，证明环境烟草烟雾是一种人类致癌物质。很多流行病学研究（包括大规模的基于人群的病例对照研究）也已经证明，在长期接触环境烟草烟雾后，肺癌的发病风险提高6。”

• 《英7国医学杂志》发表的一项 2004年的研究发现，二手烟雾接触会使非吸烟者患心脏病的风险提高60%。

• 在苏格兰，每年1500到2000例非吸烟者的死亡都归因于二手烟雾接触8。

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• 对两项在欧洲和美国分别进行的大型研究进行汇总分析后发现，接触来自配偶、工作场所或社交场合

的二手烟雾，会使从未吸烟者罹患肺癌的风险增加22%。接触时间最长的人患肺癌的风险增加了

32%9。

• 日本的一项研究得出结论，重度吸烟者的妻子患肺癌的风险是非吸烟者妻子的两倍10。

• 将在同一空间的吸烟者和非吸烟者分开并不能消除二手烟雾对健康的严重影响。美国著名的通风专业

人士协会（美国暖气、制冷、空11调工程师学会（ASHRAE））已经得出结论：通风技术并不能去除二手烟雾中全部的有害元素。

二手烟雾伤害工二手烟雾伤害工作伤害工作人员

• 据国际劳工组织估计，每年大约有20万人因在工作场所接触二手烟雾死亡12。

• 据《欧洲呼13吸杂志》2006年的一份调查报告估计，欧盟有750万工作人员在工作场所接触到二手烟雾。

• 在实施禁烟法令前，14英格兰、苏格兰、威尔士和北爱尔兰每年有54位餐饮娱乐业工作人员因接触二手烟雾死亡。

• 英国莱斯特郡的一项研究发现，酒吧的非吸烟员工体内的一氧化碳水平相当于每天吸3到5支香烟15。

• 来自新西兰的数据表明，在允许吸烟的餐饮娱乐场所工作16的不吸烟员工，其体内可替宁的含量相当于在无烟场所工作的不吸烟员工的3到4倍。

• 英国广播公司（BBC）做了一次调查，在2007年英格兰禁烟前对酒吧工作人员进行了检测，结果发

现他们体内的可替宁含量相当于每年吸300支香烟17。

二手烟雾伤害二手烟雾伤害儿童伤害儿童和孕妇儿童和孕妇和孕妇

• 全世界将近一半的儿童（大约7亿多）经常接触二手烟雾18，这增加了他们患哮喘的风险，同时也增加

了那些已患有哮喘病的孩子的发病频率和严重程度19。

• 接触二手烟雾的儿童患以下疾病的风险更高：婴儿猝死症，急性呼吸道感染，耳病，以及更严重的哮

喘病20。

• 大量的研究也21都发现，孕妇吸烟和接触二手烟雾是引起自然流产、死胎以及产后发生婴儿猝死症的主要原因。

• 《儿科杂志》发表的一项2001年6月的研究发现，不吸烟母亲所生婴儿的住院率与其在子宫中通过

母体接触二手烟雾有相关性，而且家庭成员使用烟草产品对儿童的健康有着“巨大的负面影响22。”1 This section is largely based from a document prepared by Action on Smoking and Health/United Kingdom entitled,

Fact Sheet No. 12, What’s In A Cigarette? August 2001. Available online at:

http://newash.org.uk/files/documents/ASH_117/ASH_117.html. Accessed 11.10.2007

- National Cancer Institute. Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine. Smoking and Tobacco Control Monograph No. 13. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, NIH Pub. No. 02-5074, October 2001. - Hoffman D, Hoffman I (2003). The Changing Cigarette: Chemical Studies and Bioassays.

http://dccps.nci.nih.gov/tcrb/monographs/13/m13_5.pdf. Chapter 5 of NCI Monograph 13 October 28, 2003,.

Clarification: Table 5.4 of the Monograph (that lists the 69 carcinogens) is missing a carcinogen, namely MeAaC (2-

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amino-3-methyl-9-H-pyrido[2,3-b]indole, which should be inserted under “under “Miscellaneous Organic

Compounds”. 2 For a complete list of the carcinogens in tobacco smoke, see National Cancer Institute (2001). Risks associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine. Smoking and Tobacco Control Monograph No. 13, Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, NIH Pub. No. 02-5074, October 2001. Available online at:

http://dccps.nci.nih.gov/tcrb/monographs/13/m13_5.pdf. See, also Health Harms from Secondhand Smoke. A Factsheet from the Campaign for Tobacco-Free Kids. Available online at:

3http://tobaccofreekids.org/research/factsheets/pdf/0103.pdf. Accessed on 11.10.2007 The World Health Organization, 2003. WHO Framework Convention on Tobacco Control. Available online at:

http://www.who.int/tobacco/fctc/text/final/en/. Accessed 11.10.2007 4 World Health Organization, International Agency for Research on Cancer. Tobacco Smoke and Voluntary Smoking. Monograph Series, Volume 83. Available online at:

5http://monographs.iarc.fr/ENG/Monographs/vol83/volume83.pdf. Accessed 11.10.2007 U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco

Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. Available online at: http://www.surgeongeneral.gov/library/secondhandsmoke/report. Accessed 11.01.07 6 National Toxicology Program, Public Health Service, U.S. Department of Health and Human Services (HHS) (2005). Report on Carcinogens. Eleventh Edition, January 2005. Available online at:

http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s176toba.pdf. Accessed on 11.10.2007 7 Whincup, PH et al (2004). Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement. British Medical Journal, doi:10.1136/bmj.38146.427188.55, June 30, 2004. Available online at: http://bmj.bmjjournals.com/cgi/reprint/bmj.38146.427188.55v1. Accessed on 11.10.2007 8 Hole D. (2005). Passive smoking and associated causes of death in adults in Scotland. In: A report for the Scottish Executive (2005) Edinburgh: NHS Health Scotland. Available online at:

http://www.healthscotland.com/uploads/documents/mortalitystudy.pdf. Accessed on 11.10.2007 9 P. Brennan, et al (2003). Secondhand smoke exposure in adulthood and risk of lung cancer among never smokers: A pooled analysis of two large studies. International Journal of Cancer. Vol. 109, No. 1, (December 2003), pp. 125-10131. Hirayama T. Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan. BMJ.

1981;282:183–185. Available online at: http://www.scielosp.org/pdf/bwho/v78n7/v78n7a13.pdf. Accessed

11.10.2007 11 American Society of Heating, Refrigeration and Air Conditioning Engineers (2005). Environmental Tobacco Smoke: Position Document Approved by the ASHRAE Board of Directors, June 30, 2005. Available online at: http://www.ashrae.org/content/ASHRAE/ASHRAE/ArticleAltFormat/[1**********]_347.pdf; see also, Repace, J. Controlling tobacco smoke pollution. ASHRAE IAQ Applications 6(3): 11-15, Summer 2005,

http://www.repace.com/pdf/iaqashrae.pdf. Accessed on 11.10.2007 12 Takala, J., Introductory report: decent work, safe work. International Labor Organisation, Geneva, September 2005, p. 16, http://www.ilo.org/public/english/protection/safework/wdcongrs17/intrep.pdf. Accessed on 11.10.2007 13 Jaakkola M, Jaakkola J(2006). Impact of smoke-free workplace legislation on exposures and health: possibilities for prevention. European Respiratory Journal (2006) 28:397-408. Available online at:

http://www.erj.ersjournals.com/cgi/content/abstract/28/2/397. 14 Jamrozik K (2005). Estimate of deaths attributable to passive smoking among UK adults: database analysis,” British Medical Journal. 330:812-24. Available online at: http://www.bmj.com/cgi/rapidpdf/bmj.38370.496632.8Fv3. Accessed 11.10.2007 15 Peplow, G (2007). Tests are a breath of fresh air for bar staff. Leicester Mercury, 21 August 2007. Available online at:

http://www.thisisleicestershire.co.uk/displayNode.jsp?nodeId=132384&command=displayContent&sourceNode=133130&contentPK=18155666&folderPk=77458&pNodeId=133088. Accessed on 11.10.2007 16 Bates M, Fawcett J, Dickson S, et al (2002). Exposure of hospitality workers to environmental tobacco smoke, Tobacco Control (2002) 11:125-9. Available online at: http://www.bvsde.ops-

oms.org/foro_hispano/BVS/bvsacd/cd26/tc/v11n2/125.pdf. Accessed on 11.10.2007 17 Kay, J (2007). A breath of fresh air. BBC News, 13 July 2007. Available online at:

www.globalsmokefreepartnership.org • www.tobaccofreecenter.org

http://news.bbc.co.uk/1/hi/magazine/6898124.stm. Accessed 11.10.2007 18 World Health Organization (1999). International Consultation on Environmental Tobacco Smoke (ETS) and Child Health. January 11-14, 1999. (WHO/NCD/TFI/99.10). Available online at: http://www.ash.org/who-ets-rpt.html. Accessed on 11.10.2007. See, also World Health Organization Tobacco Free Initiative (TFI) at

http://www.who.int/tobacco/framework/consultation/ets2/en/. 19 British Medical Association, Smoking and Reproductive life, February 2004. 20 U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. Available online at: http://www.surgeongeneral.gov/library/secondhandsmoke/report. Accessed 11.01.07 21 See, e.g., Shiverick, K.T. & C. Salafia, “Cigarette Smoking and Pregnancy I: Ovarian, Uterine and Placental Effects,” Placenta 20(4): 265-272, May 1999; Ness, R. B., et al., “Cocaine and Tobacco Use and the Risk of Spontaneous Abortion,” New England Journal of Medicine 340(5): 333-339, February 4, 1999; Chatenoud, L., et al., "Paternal and Maternal Smoking Habits Before Conception and During the First Trimester: Relation to

Spontaneous Abortions," Annals of Epidemiology 8(8): 520-26, November 1998; Kline, J., et al., "Smoking: A Risk Factor for Spontaneous Abortions," New England Journal of Medicine 291(15): 793-96, October 1977; Raymond, E.G. et al., “Effects of Maternal Age, Parity, and Smoking on the Risk of Stillbirth,” British Journal of Obstetric Gynaecology 101(4): 301-306, April 1994; Ahlborg, G. Jr. & L.. Bodin, “Tobacco Smoke Exposure and Pregnancy Outcome Among Working Women: A Prospective Study At Prenatal Care Centers In Orebro County, Sweden,” American Journal of Epidemiology 133(4): 338-347; February 1991; Cooke, R.W., "Smoking, Intra-Uterine Growth Retardation and Sudden Infant Death Syndrome," International Journal of Epidemiology 27(2): 238-41 (April 1998). See, also, Campaign for Tobacco-Free Kids, Harm Caused by Pregnant Women Smoking or Being Exposed to Secondhand Smoke. http://tobaccofreekids.org/research/factsheets/pdf/0007.pdf. 22 Lam, Tai-Hing, et al (2001). The Effects of Environmental Tobacco Smoke on Health Services Utilization in the First Eighteen Months of Life. Pediatrics 107(6), June 2001. See, also, Anderson, HR & DG Cook (1997). Passive Smoking and Sudden Infant Death Syndrome: Review of the Epidemiological Evidence. Thorax 52: 1003-1009, November, 1997.