Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.

BACKGROUND: Research has shown that tobacco control policies have helped produce the dramatic decline in use over the decades following the 1964 surgeon general's report. However, prevalence rates have stagnated during the past two decades in the US, even with large tobacco taxes and expansions...

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Main Author: Jason M Fletcher
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3515624?pdf=render
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author Jason M Fletcher
author_facet Jason M Fletcher
author_sort Jason M Fletcher
collection DOAJ
description BACKGROUND: Research has shown that tobacco control policies have helped produce the dramatic decline in use over the decades following the 1964 surgeon general's report. However, prevalence rates have stagnated during the past two decades in the US, even with large tobacco taxes and expansions of clean air laws. The observed differences in tobacco control policy effectiveness and why policies do not help all smokers are largely unexplained. OBJECTIVE: The aim of this study was to determine the importance of genetics in explaining response to tobacco taxation policy by testing the potential of gene-policy interaction in determining adult tobacco use. METHODS: A moderated regression analysis framework was used to test interactive effects between genotype and tobacco policy in predicting tobacco use. Cross sectional data of US adults from the National Health and Nutrition Examination Survey (NHANES) linked with genotype and geocodes were used to identify tobacco use phenotypes, state-level taxation rates, and variation in the nicotinic acetylcholine receptor (CHRNA6) genotype. Tobacco use phenotypes included current use, number of cigarettes smoked per day, and blood serum cotinine measurements. RESULTS: Variation in the nicotinic acetylcholine receptor was found to moderate the influence of tobacco taxation on multiple measures of tobacco use. Individuals with the protective G/G polymorphism (51% of the sample) responded to taxation while others had no response. The estimated differences in response by genotype were C/C genotype: b = -0.016 se = 0.018; G/C genotype: b = 0.014 se = 0.017; G/G genotype: b = -0.071 se 0.029. CONCLUSIONS: This study provides novel evidence of "gene-policy" interaction and suggests a genetic mechanism for the large differences in response to tobacco policies. The inability for these policies to reduce use for individuals with specific genotypes suggests alternative methods may be needed to further reduce use.
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spelling doaj.art-cc7fdb500ec6471986ed3a8927ec17622022-12-21T22:52:11ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01712e5057610.1371/journal.pone.0050576Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.Jason M FletcherBACKGROUND: Research has shown that tobacco control policies have helped produce the dramatic decline in use over the decades following the 1964 surgeon general's report. However, prevalence rates have stagnated during the past two decades in the US, even with large tobacco taxes and expansions of clean air laws. The observed differences in tobacco control policy effectiveness and why policies do not help all smokers are largely unexplained. OBJECTIVE: The aim of this study was to determine the importance of genetics in explaining response to tobacco taxation policy by testing the potential of gene-policy interaction in determining adult tobacco use. METHODS: A moderated regression analysis framework was used to test interactive effects between genotype and tobacco policy in predicting tobacco use. Cross sectional data of US adults from the National Health and Nutrition Examination Survey (NHANES) linked with genotype and geocodes were used to identify tobacco use phenotypes, state-level taxation rates, and variation in the nicotinic acetylcholine receptor (CHRNA6) genotype. Tobacco use phenotypes included current use, number of cigarettes smoked per day, and blood serum cotinine measurements. RESULTS: Variation in the nicotinic acetylcholine receptor was found to moderate the influence of tobacco taxation on multiple measures of tobacco use. Individuals with the protective G/G polymorphism (51% of the sample) responded to taxation while others had no response. The estimated differences in response by genotype were C/C genotype: b = -0.016 se = 0.018; G/C genotype: b = 0.014 se = 0.017; G/G genotype: b = -0.071 se 0.029. CONCLUSIONS: This study provides novel evidence of "gene-policy" interaction and suggests a genetic mechanism for the large differences in response to tobacco policies. The inability for these policies to reduce use for individuals with specific genotypes suggests alternative methods may be needed to further reduce use.http://europepmc.org/articles/PMC3515624?pdf=render
spellingShingle Jason M Fletcher
Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.
PLoS ONE
title Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.
title_full Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.
title_fullStr Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.
title_full_unstemmed Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.
title_short Why have tobacco control policies stalled? Using genetic moderation to examine policy impacts.
title_sort why have tobacco control policies stalled using genetic moderation to examine policy impacts
url http://europepmc.org/articles/PMC3515624?pdf=render
work_keys_str_mv AT jasonmfletcher whyhavetobaccocontrolpoliciesstalledusinggeneticmoderationtoexaminepolicyimpacts