Genes may determine response to nicotine patch

Researchers and experts say study findings are far too preliminary to alter current smoking-cessation strategies, but could lead to more personalized treatment of tobacco addiction.

By Victoria Stagg Elliott, AMNews staff. April 12, 2004.

Variations of a gene believed to be a significant player in the brain's reward system and frequently implicated in addiction can impact the effectiveness of nicotine replacement therapy in women, according to a study published online in the British Medical Journal last month.

The same gene variants were found in men, although they did not seem to have the same effect.

Researchers at Oxford University in England genotyped more than 750 people in 1999 and 2000. All had tried to quit smoking as participants in a 1991-1992 nicotine patch trial. Those who claimed to have maintained their nonsmoking status were tested for cotinine levels for confirmation.

At the eight-year mark, 12% of women with the CT or TT allele of the dopamine D2 receptor gene who had received the patch had remained abstinent. Only 5% of women with the CC allele had maintained their nonsmoking status. No difference based on genetics was noted in men.

"If it's replicated, and it's a genuine finding, then doctors will be able to genotype patients before recommending smoking cessation, and that would be very helpful and save people time, money, upset and disappointment," said Patricia Yudkin, PhD, lead author and a professor in medical statistics at Oxford.

Researchers suggested that this finding may mean that nicotine replacement works differently on women than on men or that smoking itself may have less to do with nicotine in women. "It could be, at least for some women, that there's much more of behavioral and social aspects involved in smoking than for men," said Dr. Yudkin.