AHRR methylation predicts smoking status and smoking intensity in both saliva and blood DNA

Am J Med Genet B Neuropsychiatr Genet. 2020 Jan;183(1):51-60. doi: 10.1002/ajmg.b.32760. Epub 2019 Aug 27.


Many existing DNA repositories do not have robust characterizations of smoking, while for many currently ongoing studies, the advent of vaping has rendered traditional cotinine-based methods of determining smoking status unreliable. Previously, we have shown that methylation status at cg05575921 in whole blood DNA can reliably predict cigarette consumption. However, whether methylation status in saliva can be used similarly has yet to be established. Herein, we use DNA from 418 biochemically confirmed smokers or nonsmokers to compare and contrast the utility of cg05575921 in classifying and quantifying cigarette smoking. Using whole blood DNA, a model incorporating age, gender, and methylation status had a receiver operating characteristic (ROC) area under the curve (AUC) for predicting smoking status of 0.995 with a nonlinear demethylation response to smoking. Using saliva DNA, the ROC AUC for predicting smoking was 0.971 with the plot of the relationship of DNA methylation to daily cigarette consumption being very similar to that seen for whole blood DNA. The addition of information from another methylation marker designed to correct for cellular heterogeneity improved the AUC for saliva DNA to 0.981. Finally, in 31 subjects who reported quitting smoking 10 or more years previously, cg05575921 methylation was nonsignificantly different from controls. We conclude that DNA methylation status at cg05575921 in DNA from whole blood or saliva predicts smoking status and daily cigarette consumption. We suggest these epigenetic assessments for objectively ascertaining smoking status will find utility in research, clinical, and civil applications.

Keywords: AHRR; methylation; saliva DNA; smoking; whole blood DNA.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Area Under Curve
  • Basic Helix-Loop-Helix Transcription Factors / blood
  • Basic Helix-Loop-Helix Transcription Factors / genetics*
  • Basic Helix-Loop-Helix Transcription Factors / metabolism
  • Biomarkers / blood
  • Cigarette Smoking / blood
  • Cigarette Smoking / genetics*
  • Cigarette Smoking / metabolism*
  • DNA / blood
  • DNA / genetics
  • DNA Methylation*
  • Epigenesis, Genetic
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nicotine / analysis
  • Nicotine / genetics
  • ROC Curve
  • Repressor Proteins / blood
  • Repressor Proteins / genetics*
  • Repressor Proteins / metabolism
  • Saliva / chemistry
  • Saliva / metabolism*
  • Smoking / genetics


  • AHRR protein, human
  • Basic Helix-Loop-Helix Transcription Factors
  • Biomarkers
  • Repressor Proteins
  • Nicotine
  • DNA