Cue-induced craving for addictive substances has long been known to contribute to the problem of persistent addiction in humans. Research in animals over the past decade has solidly established the central role of dopamine in cue-induced craving for addictive substances, including nicotine. Analogous studies in humans, however, are lacking, especially among African-American smokers, who have lower quit rates than Caucasian smokers. Based on the animal literature, the study's objective was to test the hypothesis that smokers carrying specific variants in dopamine-related genes previously associated with risk for addictive behaviors would exhibit heightened levels of cigarette craving following laboratory exposure to cues. To this end, cigarette craving was induced in healthy AfricanAmerican smokers (n ¼ 88) through laboratory exposure to smoking cues. Smokers carrying either the DRD2 (D2 dopamine receptor gene) TaqI A1 RFLP or the SLC6A3 (dopamine transporter gene) 9-repeat VNTR polymorphisms had stronger cue-induced cravings than noncarriers (Ps o0.05 and 0.01, respectively). Consistent with the separate biological pathways involved (receptor, transporter), carriers of both polymorphisms had markedly higher craving responses compared to those with neither (Po0.0006), reflecting additive effects. Findings provide support for the role of dopamine in cue-induced craving in humans, and suggest a possible genetic risk factor for persistent smoking behavior in African-American smokers. Keywords: smoking; cues; craving; nicotine; dopamine; DRD2; SLC6A3; polymorphism Despite the widely recognized risks, about one-third of the world's adult population continues to smoke cigarettes.1 According to estimates from the US, a majority of smokers attempt to quit, but only a small minority are able to maintain long-term abstinence.
2Recent population-based data have indicated that the problem of long-term abstinence is particularly salient for African-American smokers.3 While the prevalence of cigarette smoking among African Americans is comparable to that of Caucasians, survey data indicate that African-American smokers have markedly lower quit rates. 3 In spite of these figures, African Americans have been understudied in research on persistent smoking behavior. 4,5 There is thus clearly a need, both in general and regarding African-American smokers in particular, to better understand factors that may contribute to persistent smoking behavior.Early twin studies demonstrated that persistent smoking behavior (ie difficulty remaining abstinent) has a substantial genetic component.6 Providing additional support for a genetic contribution, studies over the past decade have identified two specific genetic polymorphisms in the dopamine system related to cigarette smoking behavior, as well as other types of substance abuse. [7][8][9][10][11][12][13][14][15][16] The presence of the TaqI RFLP A1 allele of the D2 dopamine receptor gene (DRD2), first found to be related to severe alcoholism, 7 has more recently been reported to be related...