Pharmacogenomics of Nicotine Dependence and Impact on Smoking Cessation

Pharmacogenomic research into smoking behaviour and smoking cessation holds promise for understanding why people smoke and how we can better help people to quit. As smoking prevalence declines in the United States and Western Europe through social and clinical action, average level of tobacco and nicotine dependence amongst smokers may increase. The place of the pharmacogenomic contribution to understanding residual dependence and how to further lower smoking prevalence may increasingly come to the fore. This review examines the influence of genetic variation on smoking initiation, progression to dependence, and persistent regular smoking (including amount smoked) as well as response to smoking cessation pharmacotherapies. Although research is still at an early stage, a future in which individualised treatment is tailored to genotype now seems possible. However, there are substantial practical, ethical, and social considerations that must be addressed before such research can be translated into clinical practice.