Exploring Potential for a Personalized Medicine Approach to Smoking Cessation with an American India
Thursday, January 19, 2023
Posted by: Natalia Gromov
Carroll
DM, Murphy S, Meier E, Rhodes K, Dorr C, Braaten G, Jacobson PA, Frizzell L,
Tyndale RF, Hatsukami D, Hernandez C.
Exploring Potential for a
Personalized Medicine Approach to Smoking Cessation with an American Indian
Tribe.
Nicotine Tob Res. 2023 Jan 1;25(1):120-126. doi: 10.1093/ntr/ntac141. PMID:
35661899; PMCID: PMC9717394.
Introduction: A
potential precision medicine approach to smoking cessation is tailoring
pharmacotherapy to a biomarker known as the nicotine metabolite ratio (NMR).
Little is known about the potential impact and acceptability of this approach
for American Indian (AI) persons.
Aims and methods: Tribal-academic
collaboration was formed and during 2019-2020 AI adults who smoke(N = 54) were
recruited to (1) examine correlations between NMR, dependence, and smoking
exposure; (2) assess the extent to which pharmacotherapy preference aligned
with NMR-informed recommendations; (3) explore acceptability of NMR-informed
pharmacotherapy selection. Participants provided samples for assessment of
salivary NMR and urinary total nicotine equivalents (TNE) and completed a
questionnaire that assessed cigarettes per day (CPD), Fagerstrom Test for Cigarette
Dependence (FTCD), pharmacotherapy preference, and perceptions of NMR-informed
pharmacotherapy selection.
Results: Significant
positive correlations were observed between NMR and FTCD (r = 0.29;p = .0383)
and its abbreviated version Heaviness of Smoking Index (HIS) (r = 0.28;p
=.0426). Post-hoc analyses suggest that relationships between dependence and
NMR were driven by time to first cigarette. Nonsignificant, but directionally
consistent, relationships were observed between NMR and CPD (r = 0.21; p
=0.1436) and TNE (r = 0.24;p = .2906). Most participants preferred nicotine
replacement therapy (71%) over varenicline (29%) and preference for
pharmacotherapy matched NMR-based recommendations in 54% of participants.
NMR-informed pharmacotherapy selection was supported by 62% of participants.
Conclusion: In
a sample of AI adults who smoke, NMR was related to cigarette dependence and
about one-half of participants' pharmacotherapy preference matched their
NMR-informed recommendation. There was lower acceptability of NMR-informed
approach in this sample of AI adults than prior studies among white or
black/African American people who smoke.
Implications: Relationships
between NMR, dependence, and self-preference for pharmacotherapy suggest that
NMR-informed pharmacotherapy selection may have potential for enhancing smoking
quitting success in this Tribe. Lower acceptability of NMR-informed
pharmacotherapy in this Tribe suggests that this approach may not be equitably
utilized. Future work could include identifying community-driven solutions to
mitigate precision medicine concerns.
|
|
Email to a Friend