It’s no secret that cigarettes kill.
Since the mid-1960s, mountains of research has proven tobacco’s nefarious link to more than 50 illnesses and diseases as diverse as cancer of the lung, throat, mouth, pancreas, kidney, bladder, penis and cervix to heart disease, osteoporosis and adult macular degeneration.
The human cost of smoking is huge. The Centers for Disease Control and Prevention estimates that smoking cost the U.S $200 billion in medical costs and loss of production each year, not to mention the 440,000 premature American deaths that occur here alone. Imagine the global cost. As Dr. Gro Harlem Brundtland, the former director-general of the World Health Organization put it, “It is rare—if not impossible—to find examples in history that match tobacco's programmed trail of death and destruction. I use the word programmed carefully. A cigarette is the only consumer product which when used as directed kills its consumer.”
Despite all the information out there, kicking the habit isn’t easy. The addictive power of nicotine is so strong that millions of people continue to smoke—despite multiple attempts to quit—even though they know that cigarettes may kill them.
Statistics show 70 percent of the 46 million U.S. smokers say they want to quit yet they haven’t found a method that works for them. In previously published reports, less than five percent of smokers who tried to quit on their own without any aids were still smokefree one year later. Long-term quit rates for smokers who relied on pharmacological intervention hover under 25 percent.
But according to new evidence from Duke University Medical Center and the National Institute on Drug Abuse (NIDA) help may be on the way.
“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.”
That’s right. A personalized approach to smoking cessation therapy may be just around the corner. By combining information about a smoker's genetic makeup with his or her smoking habits clinicians will be able to accurately predict which nicotine replacement therapy will work best.
After conducting a genome-wide scan of 520,000 genetic markers taken from blood samples of smokers in several quit-smoking trials, Rose and George Uhl, MD PhD, chief of the molecular neurobiology research at NIDA identified genetic patterns that appear to influence how well individuals respond to specific smoking cessation treatments. Researchers then formulated a “quit success score” for 479 smokers enrolled in the 12-week trial phase which involved each smoker’s own DNA and personalized information from a written questionnaire. From the score researchers could assess a smoker’s nicotine dependence and if a low dose or high dose nicotine replacement patch would work best.
“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 in a written statement. “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.”
While 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), the potential this work holds for the future is significant, Rose says.
Lynette Summerill is an award-winning writer who lives in Scottsdale, Arizona.In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.