Rate of Nicotine Metabolism and Smoking Cessation Outcomes in a Community-based Sample of Treatment-Seeking Smokers

Amanda Kaufmann; Brian Hitsman; Patricia M. Goelz; Anna Veluz-Wilkins; Sonja Blazekovic; Lindsay Powers; Frank T. Leone; Peter Gariti; Rachel F. Tyndale; Robert A. Schnoll

doi:10.1016/j.addbeh.2015.07.019

Rate of Nicotine Metabolism and Smoking Cessation Outcomes in a Community-based Sample of Treatment-Seeking Smokers

Amanda Kaufmann, Brian Hitsman, Patricia M. Goelz, Anna Veluz-Wilkins, Sonja Blazekovic, Lindsay Powers, Frank T. Leone, Peter Gariti, Rachel F. Tyndale, Robert A. Schnoll^*

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: In samples from controlled randomized clinical trials, a smoker's rate of nicotine metabolism, measured by the 3-hydroxycotinine to cotinine ratio (NMR), predicts response to transdermal nicotine. Replication of this relationship in community-based samples of treatment-seeking smokers may help guide the implementation of the NMR for personalized treatment for nicotine dependence. Methods: Data from a community-based sample of treatment seeking smokers (N. =. 499) who received 8. weeks of transdermal nicotine and 4 behavioral counseling sessions were used to evaluate associations between the NMR and smoking cessation. Secondary outcomes included withdrawal and craving, depression and anxiety, side effects, and treatment adherence. Results: The NMR was a significant predictor of abstinence (OR. =. .56, 95% CI: 0.33-0.95, p=. .03), with faster metabolizers showing lower quit rates than slower metabolizers (24% vs. 33%). Faster nicotine metabolizers exhibited significantly higher levels of anxiety symptoms over time during treatment, vs. slower metabolizers (NMR x Time interaction: F[3,357]. =. 3.29, p=. .02). NMR was not associated with changes in withdrawal, craving, depression, side effects, and treatment adherence (. p's. >. .05). Conclusions: In a community-based sample of treatment-seeking smokers, faster nicotine metabolizers were significantly less likely to quit smoking and showed higher rates of anxiety symptoms during a smoking cessation treatment program, vs. slower nicotine metabolizers. These results provide further evidence that transdermal nicotine is less effective for faster nicotine metabolizers and suggest the need to address cessation-induced anxiety symptoms among these smokers to increase the chances for successful smoking cessation.

Original language	English (US)
Pages (from-to)	93-99
Number of pages	7
Journal	Addictive Behaviors
Volume	51
DOIs	https://doi.org/10.1016/j.addbeh.2015.07.019
State	Published - Dec 1 2015

Funding

This research was supported by grants from the National Institute on Drug Abuse ( R01 DA025078 and R01 DA033681 ) and from the National Cancer Institute ( R01 CA165001 and P30 CA16520 ). Neither organization had a role in study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Funding : This research was supported by grants from the National Institute on Drug Abuse ( R01 DA025078 and R01 DA033681 ) and from the National Cancer Institute ( R01 CA165001 and P30 CA16520 ).

Keywords

Anxiety
Biomarker
Nicotine dependence
Nicotine metabolite ratio
Pharmacogenetics
Smoking cessation

ASJC Scopus subject areas

Psychiatry and Mental health
Clinical Psychology
Medicine (miscellaneous)
Toxicology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.addbeh.2015.07.019

Cite this

@article{c39b76a2364c48e190052f7d13fc93d9,

title = "Rate of Nicotine Metabolism and Smoking Cessation Outcomes in a Community-based Sample of Treatment-Seeking Smokers",

abstract = "Background: In samples from controlled randomized clinical trials, a smoker's rate of nicotine metabolism, measured by the 3-hydroxycotinine to cotinine ratio (NMR), predicts response to transdermal nicotine. Replication of this relationship in community-based samples of treatment-seeking smokers may help guide the implementation of the NMR for personalized treatment for nicotine dependence. Methods: Data from a community-based sample of treatment seeking smokers (N. =. 499) who received 8. weeks of transdermal nicotine and 4 behavioral counseling sessions were used to evaluate associations between the NMR and smoking cessation. Secondary outcomes included withdrawal and craving, depression and anxiety, side effects, and treatment adherence. Results: The NMR was a significant predictor of abstinence (OR. =. .56, 95% CI: 0.33-0.95, p=. .03), with faster metabolizers showing lower quit rates than slower metabolizers (24% vs. 33%). Faster nicotine metabolizers exhibited significantly higher levels of anxiety symptoms over time during treatment, vs. slower metabolizers (NMR x Time interaction: F[3,357]. =. 3.29, p=. .02). NMR was not associated with changes in withdrawal, craving, depression, side effects, and treatment adherence (. p's. >. .05). Conclusions: In a community-based sample of treatment-seeking smokers, faster nicotine metabolizers were significantly less likely to quit smoking and showed higher rates of anxiety symptoms during a smoking cessation treatment program, vs. slower nicotine metabolizers. These results provide further evidence that transdermal nicotine is less effective for faster nicotine metabolizers and suggest the need to address cessation-induced anxiety symptoms among these smokers to increase the chances for successful smoking cessation.",

keywords = "Anxiety, Biomarker, Nicotine dependence, Nicotine metabolite ratio, Pharmacogenetics, Smoking cessation",

author = "Amanda Kaufmann and Brian Hitsman and Goelz, {Patricia M.} and Anna Veluz-Wilkins and Sonja Blazekovic and Lindsay Powers and Leone, {Frank T.} and Peter Gariti and Tyndale, {Rachel F.} and Schnoll, {Robert A.}",

note = "Publisher Copyright: {\textcopyright} 2015 Elsevier Ltd.",

year = "2015",

month = dec,

day = "1",

doi = "10.1016/j.addbeh.2015.07.019",

language = "English (US)",

volume = "51",

pages = "93--99",

journal = "Addictive Behaviors",

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TY - JOUR

T1 - Rate of Nicotine Metabolism and Smoking Cessation Outcomes in a Community-based Sample of Treatment-Seeking Smokers

AU - Kaufmann, Amanda

AU - Hitsman, Brian

AU - Goelz, Patricia M.

AU - Veluz-Wilkins, Anna

AU - Blazekovic, Sonja

AU - Powers, Lindsay

AU - Leone, Frank T.

AU - Gariti, Peter

AU - Tyndale, Rachel F.

AU - Schnoll, Robert A.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background: In samples from controlled randomized clinical trials, a smoker's rate of nicotine metabolism, measured by the 3-hydroxycotinine to cotinine ratio (NMR), predicts response to transdermal nicotine. Replication of this relationship in community-based samples of treatment-seeking smokers may help guide the implementation of the NMR for personalized treatment for nicotine dependence. Methods: Data from a community-based sample of treatment seeking smokers (N. =. 499) who received 8. weeks of transdermal nicotine and 4 behavioral counseling sessions were used to evaluate associations between the NMR and smoking cessation. Secondary outcomes included withdrawal and craving, depression and anxiety, side effects, and treatment adherence. Results: The NMR was a significant predictor of abstinence (OR. =. .56, 95% CI: 0.33-0.95, p=. .03), with faster metabolizers showing lower quit rates than slower metabolizers (24% vs. 33%). Faster nicotine metabolizers exhibited significantly higher levels of anxiety symptoms over time during treatment, vs. slower metabolizers (NMR x Time interaction: F[3,357]. =. 3.29, p=. .02). NMR was not associated with changes in withdrawal, craving, depression, side effects, and treatment adherence (. p's. >. .05). Conclusions: In a community-based sample of treatment-seeking smokers, faster nicotine metabolizers were significantly less likely to quit smoking and showed higher rates of anxiety symptoms during a smoking cessation treatment program, vs. slower nicotine metabolizers. These results provide further evidence that transdermal nicotine is less effective for faster nicotine metabolizers and suggest the need to address cessation-induced anxiety symptoms among these smokers to increase the chances for successful smoking cessation.

AB - Background: In samples from controlled randomized clinical trials, a smoker's rate of nicotine metabolism, measured by the 3-hydroxycotinine to cotinine ratio (NMR), predicts response to transdermal nicotine. Replication of this relationship in community-based samples of treatment-seeking smokers may help guide the implementation of the NMR for personalized treatment for nicotine dependence. Methods: Data from a community-based sample of treatment seeking smokers (N. =. 499) who received 8. weeks of transdermal nicotine and 4 behavioral counseling sessions were used to evaluate associations between the NMR and smoking cessation. Secondary outcomes included withdrawal and craving, depression and anxiety, side effects, and treatment adherence. Results: The NMR was a significant predictor of abstinence (OR. =. .56, 95% CI: 0.33-0.95, p=. .03), with faster metabolizers showing lower quit rates than slower metabolizers (24% vs. 33%). Faster nicotine metabolizers exhibited significantly higher levels of anxiety symptoms over time during treatment, vs. slower metabolizers (NMR x Time interaction: F[3,357]. =. 3.29, p=. .02). NMR was not associated with changes in withdrawal, craving, depression, side effects, and treatment adherence (. p's. >. .05). Conclusions: In a community-based sample of treatment-seeking smokers, faster nicotine metabolizers were significantly less likely to quit smoking and showed higher rates of anxiety symptoms during a smoking cessation treatment program, vs. slower nicotine metabolizers. These results provide further evidence that transdermal nicotine is less effective for faster nicotine metabolizers and suggest the need to address cessation-induced anxiety symptoms among these smokers to increase the chances for successful smoking cessation.

KW - Anxiety

KW - Biomarker

KW - Nicotine dependence

KW - Nicotine metabolite ratio

KW - Pharmacogenetics

KW - Smoking cessation

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DO - 10.1016/j.addbeh.2015.07.019

M3 - Article

C2 - 26240944

AN - SCOPUS:84938310386

SN - 0306-4603

VL - 51

SP - 93

EP - 99

JO - Addictive Behaviors

JF - Addictive Behaviors

ER -

Rate of Nicotine Metabolism and Smoking Cessation Outcomes in a Community-based Sample of Treatment-Seeking Smokers

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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