The genetic determinants of smoking

Chest. 2003 May;123(5):1730-9. doi: 10.1378/chest.123.5.1730.


Dependence on tobacco, like many other drug dependencies, is a complex behavior with both genetic and environmental factors contributing to the variance. The heritability estimates for smoking in twin studies have ranged from 46 to 84%, indicating a substantial genetic component to smoking. Candidate gene studies have detected functional polymorphisms in genes coding for the cytochrome P450 enzymes, and variations in these genes that lead to more rapid nicotine metabolism have been implicated in smoking. Similarly, smoking has been associated with polymorphisms in dopaminergic genes that may influence the dopamine receptor number and/or function. Animal experiments have localized specific subunits of the nicotinic receptors that may mediate the reinforcing properties of nicotine and have investigated their role in nicotine dependence. However, environmental factors have also been found to contribute to the risk of initiation and persistence of smoking. We review the scientific evidence that supports a role for genetic influences on smoking, discuss the specific genetic and neurobiological mechanisms that may mediate susceptibility to nicotine dependence, identify possible gene/environmental interactions that may be important in understanding smoking behavior, and suggest directions for future research. Insights into the genetic contributions to smoking can potentially lead to more effective strategies to reduce smoking.

Publication types

  • Review

MeSH terms

  • Animals
  • Carrier Proteins / genetics
  • Cytochrome P-450 Enzyme System / genetics
  • Dopamine / genetics
  • Dopamine Plasma Membrane Transport Proteins
  • Genetic Linkage
  • Genetic Predisposition to Disease
  • Humans
  • Membrane Glycoproteins / genetics
  • Membrane Transport Proteins / genetics
  • Nerve Tissue Proteins*
  • Nicotine / metabolism
  • Polymorphism, Genetic
  • Serotonin Plasma Membrane Transport Proteins
  • Smoking / genetics
  • Tobacco Use Disorder / genetics*
  • Tobacco Use Disorder / metabolism
  • Twin Studies as Topic


  • Carrier Proteins
  • Dopamine Plasma Membrane Transport Proteins
  • Membrane Glycoproteins
  • Membrane Transport Proteins
  • Nerve Tissue Proteins
  • SLC6A4 protein, human
  • Serotonin Plasma Membrane Transport Proteins
  • Nicotine
  • Cytochrome P-450 Enzyme System
  • Dopamine