Nicotine Dependence and Pharmacogenetics

Abstract

Moving forward, pharmacogenetic studies that prospectively randomize participants based on genotype should be conducted in order to replicate the 'retrospective' findings obtained thus far in the context of treatment trials. Studies that investigate whether randomizing participants to different treatments based on nicotine metabolite ratio (as a pretreatment screening) increases smoking cessation rates would be a vital step toward extending the field from controlled clinical trials to clinical practice. Further, since varenicline is the most efficacious medication available, pharmacogenetic studies are needed to identify sub-groups of smokers who would benefit most from this treatment. Pharmacogenetic studies that focus on treatment efficacy should also focus on other longitudinal outcome measures such as lapses, relapses, and changes in smoking rate over time. Since treatment compliance is a significant issue in the context of treating nicotine dependence, pharmacogenetic studies of nicotine dependence trials should focus on medication side effects or discontinuation of therapy to help tailor medication choice or dose in an attempt to improve long-term quit success. Lastly, additional genetic studies are needed to examine more biologically proximal markers (i.e., endophenotypes) to help increase our understanding of nicotine dependence and identify novel candidates that can be potential targets for medication development. (PsycINFO Database Record (c) 2016 APA, all rights reserved)