{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:55:27Z","timestamp":1785297327985,"version":"3.55.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T00:00:00Z","timestamp":1684540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The nicotine metabolite ratio (NMR), a biomarker of CYP2A6-mediated nicotine metabolism, predicts the efficacy of nicotine replacement therapy (NRT), with fast metabolizers benefiting less than slow metabolizers. Whether treatment support to optimize NRT use (henceforth \u201ctreatment support\u201d) modifies this pharmacogenetic relationship is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Hospitalized adult daily smokers were assigned to one of two post-discharge smoking cessation interventions offering NRT and counseling: (1) Transitional Tobacco Care Management, which delivered enhanced treatment support via free combination NRT at discharge and automated counseling, and (2) a quitline-based approach representing usual care (UC). The primary outcome was biochemically verified 7-day point prevalence abstinence 6 months after discharge. Secondary outcomes were the use of NRT and counseling during the 3-month intervention period. Logistic regression models tested for interactions between NMR and intervention, controlling for sex, race, alcohol use, and BMI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants (N = 321) were classified as slow (n = 80) or fast (n = 241) metabolizers relative to the first quartile of NMR (0.012\u20130.219 vs. 0.221\u20133.455, respectively). Under UC, fast (vs. slow) metabolizers had lower odds of abstinence at 6 months (aOR 0.35, 95% CI 0.13\u20130.95) and similar odds of NRT and counseling use. Compared to UC, enhanced treatment support increased abstinence (aOR 2.13, 95% CI 0.98\u20134.64) and use of combination NRT (aOR 4.62, 95% CI 2.57\u20138.31) in fast metabolizers, while reducing abstinence in slow metabolizers (aOR 0.21, 95% CI 0.05\u20130.87; NMR-by-intervention interaction p = .004).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Treatment support increased abstinence and optimal use of NRT among fast nicotine metabolizers, thereby mitigating the gap in abstinence between fast and slow metabolizers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>In this secondary analysis of two smoking cessation interventions for recently hospitalized smokers, fast nicotine metabolizers quit at lower rates than slow metabolizers, but providing fast metabolizers with enhanced treatment support doubled the odds of quitting in this group and mitigated the disparity in abstinence between fast and slow metabolizers. If validated, these findings could lead to personalized approaches to smoking cessation treatment that improve outcomes by targeting treatment support to those who need it most.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntad079","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T21:02:37Z","timestamp":1684616557000},"page":"1575-1584","source":"Crossref","is-referenced-by-count":6,"title":["Can Treatment Support Mitigate Nicotine Metabolism-Based Disparities in Smoking Abstinence? Secondary Analysis of the Helping HAND 4 Trial"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0970-1941","authenticated-orcid":false,"given":"Scott S","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center , Nashville, TN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchiao","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital and Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A","family":"Rigotti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital and Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E","family":"Singer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital and Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9446-7899","authenticated-orcid":false,"given":"Douglas E","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital and Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1297-2053","authenticated-orcid":false,"given":"Rachel F","family":"Tyndale","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry, and Pharmacology and Toxicology, University of Toronto and Centre for Addiction and Mental Health , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esa M","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pittsburgh Medical Center , Pittsburgh, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S","family":"Freiberg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center , Nashville, TN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"King","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center , Nashville, TN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quinn S","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center , Nashville, TN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary A","family":"Tindle","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center , Nashville, TN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"2023081908300083300_CIT0001","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s10519-004-1327-8","article-title":"Heritability of smoking initiation and nicotine dependence","volume":"35","author":"Vink","year":"2005","journal-title":"Behav Genet."},{"key":"2023081908300083300_CIT0002","doi-asserted-by":"crossref","DOI":"10.1111\/j.1360-0443.1997.tb02847.x","article-title":"Genetic and environmental contributions to smoking","author":"True","year":"1997;92(10):1277\u20131287","journal-title":"Addiction."},{"key":"2023081908300083300_CIT0003","article-title":"The genetics of smoking initiation and quantity smoked in Dutch adolescent and young adult twins","volume-title":"Behav Genet","author":"Koopmans","year":"1999;29:383\u2013393"},{"key":"2023081908300083300_CIT0004","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajhg.2009.02.001","article-title":"Genome-wide association study of smoking initiation and current smoking","author":"Vink","year":"2009;84(3):367\u2013379","journal-title":"Am J Hum Genet."},{"key":"2023081908300083300_CIT0005","doi-asserted-by":"crossref","DOI":"10.1038\/s41467-020-18489-3","article-title":"Genome-wide association study of smoking trajectory and meta-analysis of smoking status in 842,000 individuals","author":"Xu","year":"2020;11:5302","journal-title":"Nat Commun."},{"issue":"9","key":"2023081908300083300_CIT0006","doi-asserted-by":"crossref","first-page":"e1005498","DOI":"10.1371\/journal.pgen.1005498","article-title":"A genome-wide association study of a biomarker of nicotine metabolism. 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