Laura Jean Bierut, MD of Washington University of Medicine discusses the two main nicotine responders genetic variations and metabolic enzymes. Smoking is pharmacogenetics. This means that, when they are smoking they are titrating the amount of nicotine that they are getting in their blood and in their brain. Hence, there are different responses to nicotine. Two main drivers for nicotine responses genetic variation in the nicotinic receptors and genetic variation in the enzymes that metabolize nicotine.
Drivers vary from patient to patient. So, some people can quit smoking so easily and others really struggle with smoking cessation. So, it is very important to know more about genetic variations because these are drivers of how well patients respond to medications. So, those who have the strongest genetic variation are the ones who respond best to pharmacologic treatment. Moreover, it is very important to offer more pharmacological treatment to these patients.