The A1 allele of the dopamine D2 receptor gene (DRD2) is associated with a reduced number of dopamine binding sites in the brain and with the increased likelihood of substance abuse and addictive behavior. In a study of smokers enrolled in an open-label, randomized effectiveness trial, we investigated whether variants in the DRD2 receptor gene are associated with smoking cessation outcomes following treatment with a combination of bupropion SR and behavioral counseling. Adherence to treatment and pointprevalent smoking status were assessed at 3 and 12 months, respectively, following a target quit date. Compared to women who carry both A2 alleles, women with at least one A1 allele were more likely to report having stopped taking bupropion due to medication side effects (odds ratio (OR) ¼ 1.91, 95% confidence interval (CI) ¼ 1.01-3.60; Po0.04) and at 12 months were somewhat more likely to report smoking (OR ¼ 0.76, 95% CI ¼ 0.56-1.03; Po0.076). Significant associations or trends were not observed in men. In women, individual variability in responsiveness to bupropion-based treatment may be partially due to differences in genetic variants influencing dopamine receptor function.
INTRODUCTIONTobacco use remains the major preventable cause of premature disability and death in developed countries. Despite best efforts to date, 46 million people still smoke in the United States, and over 440 000 people die each year from tobaccorelated illness; the estimated smoking-related cost to the economy is $157 billion annually.1 Effective pharmacologic interventions for smoking cessation include several forms of nicotine replacement and the use of the antidepressant medication, bupropion.2 Despite treatment advances, smoking relapse after successful intervention for smoking cessation occurs in 70 to 80% of patients within 12 months. [3][4][5] Still to be determined is why some people remain nonsmokers after pharmacologic intervention and others do not.The dopaminergic mesocorticolimbic pathway in the brain is thought to play an important role in tobacco and nicotine addiction. [6][7][8] The TaqIA polymorphism of the dopamine D2 receptor gene (DRD2) results from a C/T