Trial reportAddiction (Abingdon, England)2014
Pharmacotherapy effects on smoking cessation vary with nicotine metabolism gene (CYP2A6).
Trial report in Addiction (Abingdon, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03227679 (Metabolism-informed Care for Smoking Cessation), which is not on this map. Cited by 57 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Metabolism-informed Care for Smoking Cessation
Who cites it
57 citing papers in PubMed, 9 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Systematic Review of Naturally Derived Substances That Act as Inhibitors of the Nicotine Metabolizing Enzyme Cytochrome P450 2A6.International journal of molecular sciences · 2024Pooled it
- Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation.The Cochrane database of systematic reviews · 2023Pooled it
- The Promise of Polygenic Risk Prediction in Smoking Cessation: Evidence From Two Treatment Trials.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Pooled it
- Nicotine Metabolism Predicted by CYP2A6 Genotypes in Relation to Smoking Cessation: A Systematic Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Pooled it
- Antidepressants for smoking cessation.The Cochrane database of systematic reviews · 2020Pooled it
- Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation.The Cochrane database of systematic reviews · 2019Pooled it
- Use of polygenic risk scores of nicotine metabolism in predicting smoking behaviors.Pharmacogenomics · 2018Pooled it
- From genes to treatments: a systematic review of the pharmacogenetics in smoking cessation.Pharmacogenomics · 2018Pooled it
- Pharmacotherapy for smoking cessation: effects by subgroup defined by genetically informed biomarkers.The Cochrane database of systematic reviews · 2017Pooled it
- The clinical usefulness of knowingTumori · 2026Trial
- Use of hormonal contraceptives and smoking cessation: A preliminary report.Addictive behaviors · 2018Trial
- Does menthol cigarette use moderate the effect of nicotine metabolism on short-term smoking cessation?Experimental and clinical psychopharmacology · 2017Trial
- Test-Retest Reliability and Stability of the Nicotine Metabolite Ratio Among Treatment-Seeking Smokers.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2015Trial
- Genetic variation (CHRNA5), medication (combination nicotine replacement therapy vs. varenicline), and smoking cessation.Drug and alcohol dependence · 2015Trial
- Differential Efficacy of Nicotine Replacement Among Overweight and Obese Women Smokers.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2015Trial
- Perspectives on Using Pharmacogenomics to Guide Tobacco Cessation: Survey Results From an American Indian Community.Clinical and translational science · 2025Article
- Effect of very low nicotine content cigarettes on smoking behavior in Chinese smokers with genotype-stratified nicotine metabolism rates.Frontiers in psychiatry · 2025Article
- Changes in distinct brain systems identified with fMRI during smoking cessation treatment with varenicline: a review.Psychopharmacology · 2024Review
- Tobacco use disorder in patients with other mental disorders: a dual disorder perspective from clinical neuroscience.Frontiers in psychiatry · 2024Review
- Genomic medicine to reduce tobacco and related disorders: Translation to precision prevention and treatment.Addiction neuroscience · 2023Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsEvidence suggests that both the nicotinic receptor α5 subunit (CHRNA5) and Cytochrome P450 2A6 (CYP2A6) genotypes influence smoking cessation success and response to pharmacotherapy. We examine the effect of CYP2A6 genotype on smoking cessation success and response to cessation pharmacotherapy, and combine these effects with those of CHRNA5 genotypes.
designPlacebo-controlled randomized smoking cessation trial.
settingAmbulatory care facility in Wisconsin, USA.
participantsSmokers (n = 709) of European ancestry were randomized to placebo, bupropion, nicotine replacement therapy or combined bupropion and nicotine replacement therapy. MEASUREMENTS: Survival analysis was used to model time to relapse using nicotine metabolism derived from CYP2A6 genotype-based estimates. Slow metabolism is defined as the lowest quartile of estimated metabolic function.
findingsCYP2A6-defined nicotine metabolic function moderated the effect of smoking cessation pharmacotherapy on smoking relapse over 90 days [hazard ratio (HR) = 2.81, 95% confidence interval (CI) = 1.32-5.99, P = 0.0075], with pharmacotherapy significantly slowing relapse in fast (HR = 0.39, 95% CI = 0.28-0.55, P = 1.97 × 10(-8)), but not slow metabolizers (HR = 1.09, 95% CI = 0.55-2.17, P = 0.80). Further, only the effect of nicotine replacement, and not bupropion, varies with CYP2A6-defined metabolic function. The effect of nicotine replacement on continuous abstinence is moderated by the combined genetic risks from CYP2A6 and CHRNA5 (Wald = 7.44, d.f. = 1, P = 0.0064).
conclusionsNicotine replacement therapy is effective among individuals with fast, but not slow, CYP2A6-defined nicotine metabolism. The effect of bupropion on relapse likelihood is unlikely to be affected by nicotine metabolism as estimated from CYP2A6 genotype. The variation in treatment responses among smokers with genes may guide future personalized smoking cessation interventions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.