Association of Three Biomarkers of Nicotine as Pharmacogenomic Indices of Cigarette Consumption in Military Populations [Dissertation].

Tobacco-related diseases have reached epidemic proportions. There is no risk-free level of tobacco exposure. In the United States, tobacco use is the single largest preventable cause of death and disease in both men and women. Cigarette smoking alone accounts for approximately 443,000 deaths per year (one fifth of total US deaths) costing a staggering $193 billion per year in avoidable healthcare expenses and lost productivity. Literature shows military populations have rates of tobacco use two to three times higher than the civilian population. Military personnel returning from deployment in conflict areas can exceed 50% smoking prevalence. Research shows that genetic factors account for 40-70% of variation in smoking initiation and 50-60% of variance in cessation success. In the U.S., tobacco is responsible for more deaths than alcohol, AIDS, car accidents, illegal drugs, murders and suicides combined. This descriptive, cross-sectional study examined three of the biological markers used in tobacco research: the α4β2 brain nicotinic receptors (nAChR) that contribute to genetic risk for nicotine dependence, nicotine metabolite ratio (NMR) as a phenotypic marker for CYP2A6 activity, and bitter taste phenotype (BTP) to determine their impact on cigarette consumption in military populations. Sociodemographic and military variables were examined to determine if they impacted biomarker relationships. The availability of reliable biomarkers will facilitate development of personalized smoking cessation therapies for military personnel.