Prom-Wormley Elizabeth C, Wells Jonathan L, Landes Lori, Edmondson Amy N, Sankoh Mariam, Jamieson Brendan, Delk Kayla J, Surya Sanya, Bhati Shambhavi, Clifford James
Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States.
Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States.
Front Genet. 2023 Jun 8;14:1103966. doi: 10.3389/fgene.2023.1103966. eCollection 2023.
Abstinence rates among smokers attempting to quit remain low despite the wide availability and accessibility of pharmacological smoking cessation treatments. In addition, the prevalence of cessation attempts and abstinence differs by individual-level social factors such as race and ethnicity. Clinical treatment of nicotine dependence also continues to be challenged by individual-level variability in effectiveness to promote abstinence. The use of tailored smoking cessation strategies that incorporate information on individual-level social and genetic factors hold promise, although additional pharmacogenomic knowledge is still needed. In particular, genetic variants associated with pharmacological responses to smoking cessation treatment have generally been conducted in populations with participants that self-identify as White race or who are determined to be of European genetic ancestry. These results may not adequately capture the variability across all smokers as a result of understudied differences in allele frequencies across genetic ancestry populations. This suggests that much of the current pharmacogenetic study results for smoking cessation may not apply to all populations. Therefore, clinical application of pharmacogenetic results may exacerbate health inequities by racial and ethnic groups. This scoping review examines the extent to which racial, ethnic, and ancestral groups that experience differences in smoking rates and smoking cessation are represented in the existing body of published pharmacogenetic studies of smoking cessation. We will summarize results by race, ethnicity, and ancestry across pharmacological treatments and study designs. We will also explore current opportunities and challenges in conducting pharmacogenomic research on smoking cessation that encourages greater participant diversity, including practical barriers to clinical utilization of pharmacological smoking cessation treatment and clinical implementation of pharmacogenetic knowledge.
尽管药物戒烟治疗广泛可得且易于获取，但尝试戒烟的吸烟者的戒烟率仍然很低。此外，戒烟尝试和戒烟的流行率因种族和族裔等个体层面的社会因素而异。尼古丁依赖的临床治疗也继续受到个体层面促进戒烟有效性差异的挑战。采用纳入个体层面社会和遗传因素信息的量身定制的戒烟策略有望取得成效，尽管仍需要更多的药物基因组学知识。特别是，与戒烟治疗药物反应相关的基因变异通常是在自我认定为白人种族或被确定具有欧洲遗传血统的参与者群体中进行研究的。由于对不同遗传血统人群的等位基因频率差异研究不足，这些结果可能无法充分反映所有吸烟者的变异性。这表明目前许多关于戒烟的药物遗传学研究结果可能不适用于所有人群。因此，药物遗传学结果的临床应用可能会加剧不同种族和族裔群体之间的健康不平等。本综述探讨了在已发表的戒烟药物遗传学研究中，吸烟率和戒烟存在差异的种族、族裔和祖先群体的代表性程度。我们将按种族、族裔和祖先总结药物治疗和研究设计的结果。我们还将探讨当前在进行鼓励更大参与者多样性的戒烟药物基因组学研究方面的机遇和挑战，包括药物戒烟治疗临床应用的实际障碍和药物遗传学知识的临床实施。
