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Editorial |

Pharmacogenetics and Ethnoracial Differences in Smoking

Edward M. Sellers, MD, PhD
JAMA. 1998;280(2):179-180. doi:10.1001/jama.280.2.179.
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More than 1.1 billion people smoke tobacco worldwide, but they do so in different patterns and with strikingly different consequences.1 For example, more than 50% of Japanese men smoke, yet Japanese smokers have among the lowest risks of lung cancer (corrected for smoke exposure) of all ethnoracial groups.1 African Americans, who, compared with Caucasian Americans, smoke fewer cigarettes but inhale more deeply and are more likely to choose mentholated brands, achieve higher net indexes of smoke exposure and have the potential for greater physical dependence and exposure to more smoke toxins.2,3 African Americans also have a higher incidence of and mortality from lung cancer and a lower incidence of and mortality from chronic obstructive pulmonary disease (COPD) than Caucasian Americans.4 While sociocultural factors can account for some of these differences, equally important are underlying basic biologic differences among ethnoracial groups in how nicotine and other substances in tobacco smoke are metabolized.

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