Personalized Medicine and Tobacco-Related Health Disparities: Is There a Role for Genetics?

Abstract

Genetic testing has been proposed as a means to increase smoking cessation rates and thus reduce smoking prevalence. To understand how that might be practically possible, with appreciation of the current social context of tobacco use and dependence, we performed a contextual analysis of smoking-related genetics and smoking cessation. To provide added value, genetics would need to inform and improve existing interventions for smokers (including behavioral and pharmacological treatments). Pharmacogenetics offers the most promising potential, because it may improve the effi cacy of medication-based smoking cessations strategies. All proven interventions for treating tobacco dependence, however, including simple cost-effective measures, such as quit lines and physician counseling, are underutilized. As tobacco use occurs disproportionately among disadvantaged populations, efforts to improve smokers' access to health care, and to the tools that are known to help them quit, represent the most promising approaches for reducing smoking prevalence within these groups. Similar considerations apply to other chronic diseases contributing to population-level health disparities. We conclude that although genetics offers increasing opportunities to tailor drug treatment, and may in some cases provide useful risk prediction, other methods of personalizing care are likely to yield greater benefi t to populations experiencing health disparities related to tobacco use.

Impact of Genetic Notification on Smoking Cessation: Systematic Review and Pooled-Analysis

“…mass media, package warning and bans). As the evidence for benefit of these interventions is strong and well-established, it is incumbent upon genetics to demonstrate additional benefit [47] .…”

Genetic similarities between tobacco use disorder and related comorbidities: an exploratory study

“…Previous publications such as Carlsten et al already pointed out the benefits of personalized medicine in TUD [ 26 ]. Due to the strong evidence that genetic factors are involved in nicotine addiction and smoking cessation, interventions should be adapted in terms of the type of treatment, the dose, and the duration.…”

Pathways to precision medicine in smoking cessation treatments

“…To implement precision medicine for smoking cessation treatment, there are potential barriers. Some people remain skeptical for the value of genetic testing while proven interventions for treating tobacco dependence, including simple cost-effective measures, such as quit lines which are underutilized [116]. Furthermore, whether the use of personalized genomic information can be used to promote behavior change remains a topic of debate [117].…”