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  • The authors addressed this question using a meta analytic

    2018-11-14

    The authors addressed this question using a meta-analytic approach involving 15 studies that examined more than 12,000 smokers (). The study found that there were no differences in the benefits of quitting based on CHRNA5 allelic status. Consistent with many previous studies the benefits of quitting smoking, even for individuals with a long history of smoking, were quite large, much larger than the risk associated with CHRNA5 variant alone. Of course, this study addressed variation in only one risk locus, which by itself is likely to contribute only a small percentage of the overall risk, as appears to be the case for addiction genetics generally (). Nonetheless, it tells a rather important tale about the relationship between lung cancer risk and the underlying genotype-phenotype relationships that are important for understanding health outcomes associated with genetic risk in smoking. It will be important in future studies to address the nature of the greater, collective genetic contribution to lung cancer risk. Is the majority of this risk due to genetic influences on smoking behavior and psychological processes as opposed to a more fundamental biological predisposition to the development or progression of lung cancer? This question has important implications for the overlapping fields of lung cancer research/treatment and nicotine dependence research/treatment. If the majority of the Z-YVAD-FMK involved in the predisposition to lung cancer are behavioral, then lung cancer treatment and prevention approaches need to take this into account. In the broadest sense this has public Z-YVAD-FMK policy implications for governmental spending on research and treatment efforts in this area. A few years ago there was a suggested merger of the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. There were certainly reasons for and against the potential merger (), that eventually weighed into the decision not to merge the institutes. One of the issues that came out in the debate, however, surrounded the large research portfolio dedicated to lung cancer research within the National Cancer Institute, and whether future directions in lung cancer research/treatment efforts (and funding) might be more profitably directed a bit more towards the research and treatment of nicotine dependence. The present findings would seem to suggest that addictive behavior really lies behind genetic contributions to lung cancer, at least for this “lung cancer” locus, although certainly more remains to be done to assess the nature of the wider genetic contributions to lung cancer risk. Disclosure
    The use of technology in healthcare is transforming, not only our access to medical information, but improving patient care. For example, the electronic medical record (EMR) permits the instant availability of medical information to specialists who are providing care across hospitals (). On the patient level, adaptive devices assist with monitoring blood pressure (), glucose levels (), physical activity () and even sleep (). Physicians are now encouraging patients to transmit pictures via their cell phone to inspect rashes or dangerous-looking moles before they become melanoma. Telemedicine is also allowing university and tertiary care hospitals to deliver expert advice or to assist with a diagnosis in remote areas around the world. As we work through security and privacy issues, the use of technology, in this innovative way, has the potential of transforming medicine for both the professional staff and patients seeking care. As portable electronic devices become more accessible around the globe, the use of these devices to capture behavior and cognitive test performance is also appealing. It is possible that evaluating individuals with suspected dementia in the privacy of their own home may provide more reliable information than an in-clinic visit (). As with all of these technologies, practical and scientific questions need to be addressed in order to determine if they provide reliable and valid information in contrast to in-clinic or face-to-face assessments.