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Genetic Advances Help People Kick the Habit

Authorities say progress in pharmacogenetics, the personalization of medications based upon an individual’s genetic makeup, will help individuals stop smoking.

New evidence from Duke University Medical Center and the National Institute on Drug Abuse (NIDA) suggests that combining information about a smoker’s genetic makeup with his or her smoking habits can accurately predict which nicotine replacement therapy will work best.

“Within three to five years, it’s conceivable we’ll have a practical test that could take the guesswork out of choosing a smoking-cessation therapy,” says Jed Rose, Ph.D., director of Duke’s Center for Nicotine and Smoking Cessation Research.

“It could be used by clinicians to guide the selection of treatment and appropriate dose for each smoker, and hopefully increase cessation success rates.”

Statistics show 70 percent of the nation’s 46 million smokers say they want to quit, yet successfully kicking the habit has not proven easy.

In previously published reports, less than five percent of smokers who tried to quit on their own without any aids were not smoking one year later. Long-term quit rates for smokers who relied on pharmacological intervention hover under 25 percent.

The research, which is published online in the July-August issue of Molecular Medicine, follows previous work done by Rose and George Uhl, MD, PhD, chief of the molecular neurobiology research at NIDA.

After conducting a genome-wide scan of 520,000 genetic markers taken from blood samples of smokers in several quit-smoking trials, they identified genetic patterns that appear to influence how well individuals respond to specific smoking cessation treatments.

The latest research focuses on combining the information from those individual genetic markers, called SNPs, into one number that represents a “quit success score,” Rose says.

The score and the smokers’ nicotine dependence, assessed via a simple questionnaire, help predict an individual’s likelihood of quitting, as well as whether a high-dose or low-dose nicotine patch would work best.

In the trial, 479 cigarette smokers who smoked at least 10 cigarettes per day and wanted to quit were categorized as either high- or low-dependence based on their level of nicotine dependence.

The smokers in each group were then randomly assigned to wear two nicotine skin patches daily delivering a high dose (42 mg) or a standard dose (21 mg). Patches were worn for two weeks prior to their quit date, and the nicotine doses were reduced gradually over the 10 weeks following their quit date.

Participants were given denicotinized cigarettes during the two weeks before the quit date to minimize any potential adverse effects from the high dose nicotine patches.

The treatment phase lasted for 12 weeks in all.

DNA was extracted from participants’ blood and was used to assess a quit-smoking success genetic score.

At six months followup, the researchers were able to confirm which smokers fared better or worse on the high-dose compared to the low-dose patch.

“The genotype score was part of what predicted successful abstinence. In the future such a score could help us make our initial treatment decisions,” said Rose.

“People who had both high nicotine dependence and a low or unfavorable quit success genetic score seemed to benefit markedly from the high-dose nicotine patch, while people who had less dependence on nicotine did better on the standard patch.”

Further studies are needed to replicate these results, and to expand the research to include therapies like verenicline (Chantix, Pfizer) and bupropion hydrochloride (Zyban, Glaxo SmithKline). But the potential this work holds for the future is significant, Rose says.

“Right now there is no treatment algorithm that tells a clinician or smoker which treatment is likely to work for them,” says Rose. “That’s what we are trying to do. We want to tailor and give informative guidance to clinicians in terms of what should be tried first to maximize smoking cessation success.”

Source: Duke University Medical Center

Genetic Advances Help People Kick the Habit

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Genetic Advances Help People Kick the Habit. Psych Central. Retrieved on May 20, 2018, from https://psychcentral.com/news/2010/07/12/genetic-advances-help-people-kick-the-habit/15477.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.