Caution Advised in Genetics Research on Smoking

Chris Carlsten, MD, MPH
University of Washington
P30ES007033

In a commentary in the Journal of the American Medical Association, NIEHS-supported scientist Dr. Chris Carlsten, along with a colleague at the University of Washington, warns that the potential for genetic testing and subsequent risk identification might not be good public health practice regarding cigarette smoking.

Carlsten cites two approaches where genetic testing might improve rates of getting smokers to successfully kick their habits. Genetic testing could be used to warn individuals at higher risk of lung cancer and subsequently increase their motivation to stop smoking. Also, genetic testing might identify candidates for more intensive cessation programs based on increased cancer risk or conceivably help determine more effective cessation approaches such as drug therapy based on the genotypes of individual smokers. In contrast, Carlsten goes on to point out that data currently available on genotype and risk are not necessarily highly motivating in modifying behavior. The data suggest that knowledge of small increases in risk of disease is insufficient in motivating smokers to quit. In addition, there is little evidence that nicotine therapy tailored to individual genotypes is effective.

For these reasons, and to reduce the risks of bystanders from second hand smoke inhalation, Carlsten recommends the more standard, societal approaches for getting smokers to quit including smoking bans in public areas, high taxes on tobacco products, and government-sponsored anti-smoking campaigns.

Citation: Carlsten C, Burke W. Potential for genetics to promote public health: genetics research on smoking suggests caution about expectations. JAMA. 2006 Nov 22;296(20):2480-2.