Individual differences in propensity to nicotine dependence appear to be mediated, in part, by genetic factors. 1 The serotonin transporter gene has a functional polymorphism (5-HTTLPR) which modulates gene transcription and reuptake. 2,3 A possible role in nicotine dependence is suggested by a link between 5-HTTLPR and neuroticism, 4 a personality trait which has been related to smoking practices. 5 In a cross-sectional study of 185 smokers, we utilized multiple linear regression modeling to examine the interacting effects of the 5-HTTLPR and neuroticism on smoking practices and nicotine dependence. Genotype was classified according to the presence or absence of the short (s) allele vs the long (l) allele of 5-HTTLPR (ie, s/s or s/l vs l/l). Models controlled for gender, age, race, and alcohol use. The 5-HTTLPR by neuroticism interaction effect was statistically significant in the models of nicotine intake (P = 0.05), nicotine dependence (P = 0.001), and smoking motivations (smoking to reduce negative mood (P = 0.01); smoking for stimulation (P = 0.01)). The results suggested that neuroticism was positively associated with these smoking practices among smokers with 5-HTTLPR S genotypes (s/s or s/l), but not among smokers with the L genotype (l/l). The 5-HTTLPR may modify the effects of neuroticism on smoking motivations and nicotine dependence. Assessment of 5-HTTLPR genotype and neuroticism may help to identify smokers who are more responsive to psychotropic medications, such as selective serotonin reuptake inhibitors (SSRIs), which are being used in smoking cessation treatment. Molecular Psychiatry (2000) 5, 189-192. Individual differences in propensity to nicotine dependence are mediated in part by genetic factors. 1 Previous studies have linked smoking behavior with genes involved in the regulation of the neurotransmitter dopamine. 6,7 This is biologically plausible, because the reinforcing properties of nicotine have been attributed to its effects on dopamine transmission and stimulation of the reward pathways. 8 Another candidate gene for smoking behavior encodes for the serotonin transporter which regulates synaptic reuptake in the brain. 2 Gene transcription has been reported to be modulated by a polymorphism (5-HTTLPR), resulting in a long allele (l = long) vs a short allele (s = short). 3 The s allele is associated with reduced transcription and has been linked with neuroticism, an anxietyrelated personality trait. 4 However, the association with personality has not been supported in subsequent studies. 9,10 Although we did not find evidence for a main effect of 5-HTTLPR on smoking status in a previous analysis, 11 Hu and colleagues 12 have provided evidence that the 5-HTTLPR modifies the association of neuroticism with smoking status. In the present report, we sought to replicate and extend the findings by Hu et al 12 examining the interacting effects of the 5-HTTLPR and neuroticism on smoking practices and nicotine dependence in an independent sample of smokers.The study sample included 185 smoke...