Genetics of Nicotine Addiction-Examining Ethics & Policy

描述（由申请人提供）：研究正在进行中，以检查影响吸烟开始，尼古丁依赖和无法戒烟的遗传因素。其他研究使用DNA阵列技术来绘制尼古丁在大脑中引起的变化。通过更好地了解与尼古丁成瘾有关的生物学机制，这一正在展开的遗传研究有望推动药物遗传学的发展，创造新的基因测试，并最终为戒烟和预防性干预的创新战略提供基础。将基因研究的成果转化为公共健康或治疗项目将需要解决一系列复杂的伦理、法律、社会和政策问题。吸烟的“基因化”可能会给吸烟者带来额外的耻辱，或者将成瘾的责任从香烟（和烟草行业）转移到个人的基因构成上。关键的问题将伴随着测试：谁应该被认为有风险？种族群体会成为攻击目标吗？对服务的访问将如何受到影响？我们应该使用精神药物来预防吸烟吗？拟议的研究将把实证调查与伦理和政策分析结合起来，采用一系列方法：系统审查科学文献和烟草业文件，与利益攸关方面谈，在科学会议上进行人种学研究，以及一个多学科的国家咨询委员会。该项目的经验目标是：1)评估有关吸烟行为和尼古丁成瘾易感性的遗传基础的科学知识状况；2)基于这些知识预测和描述临床和预防性健康应用；3)检查烟草控制关键利益相关者中吸烟遗传理解的出现。根据我们的经验工作，并与项目顾问委员会协商，伦理和政策目标是：4)描述和评估基因解释对现有吸烟控制政策（如公共卫生战略和治疗方案）的可预见影响；5)识别和分析基因理解吸烟行为的关键伦理、法律和社会后果。该项目的目标是为政策制定者提供对基因研究的潜在影响和局限性的清晰理解，确保遗传学将和谐地融入减少烟草使用的措施中，并通过提供尼古丁成瘾的全面分析-行为遗传学研究中固有的伦理复杂性的例证-为有关成瘾遗传学的公共政策辩论做出贡献。

DESCRIPTION (provided by applicant): Studies are underway to examine the genetic factors contributing to smoking initiation, nicotine dependence, and inability to quit. Other studies use DNA array technologies to map nicotine-induced alterations in the brain. By providing a better understanding of the biological mechanisms involved in nicotine addiction, this unfolding body of genetic research is expected to fuel developments in pharmacogenetics, to create new genetic tests, and ultimately, to provide the basis for innovative strategies for smoking cessation and preventive interventions. Translating the results of genetic research into public health or treatment programs will require the resolution of a host of complex ethical, legal, social, and policy issues. The "geneticization" of smoking may cast additional stigma on smokers, or shift responsibility for addiction away from the cigarette (and the tobacco industry) and onto individuals' genetic make-up. Crucial issues will accompany testing: Who should be considered at risk? Will racial groups be targeted? How will access to services be affected? Should we use psychotropic drugs to prevent smoking? The proposed research will combine empirical investigation with ethical and policy analysis, employing a range of methods: systematic review of the scientific literature and of tobacco industry documents, interviews with stakeholders, ethnographic research at scientific meetings, and a multi-disciplinary, national Advisory Board. The project's empirical aims are to: 1) assess the state of scientific knowledge about the genetic basis of smoking behaviors and susceptibility to nicotine addiction, 2) anticipate and characterize clinical and preventive health applications based on this knowledge, and 3) examine the emergence of a genetic understanding of smoking among key stakeholders in tobacco control. Informed by our empirical work, and in consultation with the project's Advisory Board, the ethical and policy aims are to: 4) delineate and evaluate the foreseeable impact of genetic explanations on existing smoking control policies, such as public health strategies and treatment programs, and, 5) identify and analyze key ethical, legal, and social consequences of a genetic understanding of smoking behaviors. The goal of the project is to provide policy makers with a clear understanding of the potential impacts and limitations of genetic research, ensure that genetics will integrate harmoniously in measures to reduce tobacco use, and contribute to the public policy debate about the genetics of addiction, by providing a comprehensive analysis of nicotine addiction - an illustration of the ethical complexities inherent in behavioral genetics research.