Smoking, Genes, and Volcanos – Oh My!

Dr. Thorgeirsson's slide on the Icelandic volcanos. (Photo by Sherry Boschert)

From the annual meeting of the American Society of Addiction Medicine.

The lives of thousands of physicians, reporters, and others have been disrupted by a volcano whose name they can barely pronounce. Can you say Eyjafjallajokull? Does it even help to see a phonetic spelling (EYE-a-fyat-la-jo-kutl)? For me, not so much. For more giggles, try pronouncing the name of the glacier next to it—Myrdalsjokull—which covers the even larger Katla volcano that very well may go off within the next couple of years, causing even more travel mayhem.

During a talk on the genetics of nicotine addiction, Thorgeir E. Thorgeirsson, Ph.D., director of medical genetics at the University of California, Santa Cruz, diverged briefly to talk about the big, bad smokers in his native Iceland. Take a listen:

The genetics involved in the other kind of smoking—the kind that involves cigarettes and nicotine addiction—also will likely have a huge effect on lives, though its applications aren’t quite ready for clinical practice. Dr. Thorgeirsson noted that “For the price of a fancy car, you can have your genome sequenced. The price is dropping rapidly.” Although he acknowledged that researchers are “still stumbling in the darkness” trying to understand the genetic influences on addiction, they’re starting to learn enough that he suggested, “Perhaps our definitions of nicotine dependence need to be addressed” to incorporate genetic underpinnings.

Individuals respond differently to drugs of abuse because innate differences protect or predispose them to addiction, added another speaker in the same session, Dr. Laura Bierut of Washington University, St. Louis. She and other researchers already have identified gene variants that appear to contribute to nicotine or cocaine dependency, but some startling findings make them wonder how these might eventually prove useful clinically.

“We were shocked” to find that each time a gene variant was identified as a risk factor for nicotine dependence, it appeared to be protective against cocaine dependence, and vice versa, she said. The implications raise concerns about possibly designing gene-based treatments to reduce one kind of dependency and having it boomerang by increasing the risk of another kind of dependence.

So far, the only clinically useful knowledge in this area is the risk of addiction within families. If parents have substance dependence or addiction problems, their children are highly likely to have the same vulnerabilities. Young patients need to hear this, and pediatricians need to know if a parent is addicted in order to best help their patients, she said.

–Sherry Boschert (@sherryboschert on Twitter)
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Filed under Cardiovascular Medicine, Family Medicine, Genomic medicine, IMNG, Internal Medicine, Medical Genetics, Oncology, Pulmonary Diseases and Sleep Medicine

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