By Siteman Communications


Making discoveries that can advance clinical practices and close the gap between health and racial disparities is inspiring for researchers.

There is a great need to examine the racial disparities in healthcare and how we can help those who are most vulnerable and disproportionally affected by smoking related disease, such as lung cancer, COVID-19 and early mortality.

Quitting smoking may bring back up to 10 years of life and can lead to numerous health improvements, even among cancer patients. With the long-standing systemic health inequality of African Americans, some communities are at higher risk for COVID-19 and more severe outcomes from the illness. Kicking the habit is hard, but personalized medicine has potential to help those who are most vulnerable to quit smoking.

With high interest in personalized medicine, are we ready?

Li-Shiun Chen, MD, MPH, ScD

Li-Shiun Chen, MD, MPH, ScD, an associate professor and board-certified psychiatrist, conducted a genetically informed smoking cessation trial directly comparing two of the most effective smoking cessation drugs (nicotine patch plus nicotine lozenge versus Chantix).

Chen’s study found that treatment response differs based on genetics for African American smokers. Smokers with low risk genotypes quit better when treated with a combination of nicotine patches and nicotine lozenges, while those with high risk genotypes, quit better with Chantix. We still need more data to clarify the trend in European ancestry smokers.

Personalized medicine for smoking cessation in the future may be possible if doctors use genetics to help choose the most effective therapies. More evidence is needed to understand the racial differences in treatment response. These findings enhance our ability to improve the health disparities among African American smokers whose risk, prevalence, and mortality from smoking-related diseases are disproportionately high.

Chen LS, Baker TB, Miller JP, Bray M, Smock N, Chen J, Stoneking F, Culverhouse RC, Saccone NL, Amos CI, Carney RM, Jorenby DE, Bierut LJ. Genetic variant in CHRNA5 and response to varenicline and combination nicotine replacement in a randomized placebo-controlled trial. Clin Pharmacol Ther. 2020 Jun 29. doi: 10.1002/cpt.1971.

This work was supported by the National Institutes of Health (NIH), grant number R01 DA038076

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Originally published by Siteman Cancer Center