'Metabolizer Test' Might Someday Take Guesswork Out of Quitting Smoking

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Determining how quickly or slowly you process nicotine might be an aid to quitting, study suggests

WebMD News from HealthDay
By Alan Mozes
HealthDay Reporter
MONDAY, Jan. 12, 2015 (HealthDay News) -- Quitting smoking is notoriously tough, and some smokers may try different approaches for years before they succeed, if ever.
But new research suggests that someday, a simple test might point smokers toward the quitting strategy that's best for them.
It's been long theorized that some smokers are genetically predisposed to process and rid the body of nicotine more quickly than others. And now a new study suggests that slower metabolizers seeking to kick the habit will probably have a better treatment experience with the aid of a nicotine patch than the quit-smoking drug varenicline (Chantix).
The finding is based on the tracking of more than 1,200 smokers undergoing smoking-cessation treatment. Blood tests indicated that more than 660 were relatively slow nicotine metabolizers, while the rest were normal nicotine metabolizers.
Over an 11-week trial, participants were prescribed a nicotine patch, Chantix, or a non-medicinal "placebo."
As reported online Jan. 11 in The Lancet Respiratory Medicine, normal metabolizers fared better using the drug compared with the nicotine patch.
Specifically, 40 percent of normal metabolizers who were given the drug option were still not smoking at the end of their treatment, the study found. This compared with just 22 percent who had been given a nicotine patch.
Among the slow-metabolizing group, both treatments worked equally well at helping smokers quit, the researchers noted. However, compared with those treated with the nicotine patch, slow metabolizers treated with Chantix experienced more side effects.
This led the team to conclude that slow metabolizers would fare better -- and likely remain cigarette-free -- when using the patch.
The study was led by Caryn Lerman, a professor of psychiatry and director of the Center for Interdisciplinary Research on Nicotine Addiction at the University of Pennsylvania School of Medicine. She believes that the findings show that not all smokers are alike, and measuring each smokers' "nicotine metabolite ratio" might someday be a useful tool "to guide treatment choices."
"This is a much-needed, genetically informed [measurement tool] that could be translated into clinical practice," Lerman said in a university news release. "Matching a treatment choice based on the rate at which smokers metabolize nicotine could be a viable strategy to help guide choices for smokers and ultimately improve quit rates."