# Developing Personalized Smoking Treatment in the Southern Community Cohort Study

> **NIH NIH U54** · TENNESSEE STATE UNIVERSITY · 2020 · $79,778

## Abstract

SUMMARY
Cigarette smoking increases the risk of multiple cancers, accounting for more than 30% of all cancer deaths and 80%
of deaths from lung cancer. Disparities exist in smoking-related disease burden by socioeconomic and racial/ethnic
status, and the cancer survival gap between blacks and whites has failed to close in 2 decades. Improved strategies
are needed for underserved groups. Personalizing standard care with biological data to 1) enhance accuracy
of lung cancer risk or 2) measure speed of nicotine metabolism to inform pharmacotherapy choice is a
promising yet understudied approach in low income minority smokers. Such biologically-informed personalized
treatment could benefit smokers by increasing motivation to quit, improving the accuracy of smoking-related health
risk perceptions, or via other mechanisms. Smokers undergoing the gene-based lung cancer risk assessment,
Respiragene (developed by Dr. Young, consultant) were more likely to undergo lung cancer screening, use nicotine
replacement therapy (NRT) and quit smoking. Another promising tool for personalized intervention is the nicotine
metabolite ratio (NMR), a biomarker reflecting the ratio of two nicotine metabolites (3'hydroxycotinine/cotinine) that
closely approximates CYP2A6 gene activity. The NMR is considered the emerging biomarker of choice to measure
nicotine metabolism, which can be dichotomized as “fast/normal” vs “slow.” Trial data from Dr. Tyndale (consultant)
show that NMR informs choice of smoking cessation pharmacotherapy such that “fast/normal” metabolizers are twice
as likely to quit smoking on varenicline compared to “slow” metabolizers. Neither of these promising interventions
have been studied in vulnerable smokers receiving health care in the community. Taken together, these preliminary
data set a compelling stage for personalized treatment of smoking in the Southern Community Cohort Study (SCCS).
Our overarching aim is to leverage the SCCS and the Outreach Core Community Advisory Board (CAB) to
guide the development of two personalized care (PC) interventions for smoking cessation: PC-Respiragene
and PC-NMR. PC-Respiragene and PC-NMR are rooted in the PRIME Model of behavior change which reflects a
multi-faceted view of motivation for tobacco cessation. Both will be tailored to attitudes and beliefs of low
socioeconomic status (defined as majority of the population < 100% federal poverty level) smokers in the
southeastern US, where tobacco use prevalence is very high. Aim 1 will survey SCCS smokers residing in
Tennessee and Mississippi to assess attitudes and beliefs on smoking-related health risk perceptions, personalized
smoking treatment, and willingness to join a smoking cessation trial of PC (n=1647). Aim 2 will leverage CAB input
to develop PC-Respiragene and PC-NMR for use among diverse, low SES community smokers in the SCCS. Aim 3
will conduct a 3-arm RCT (N=75) SCCS smokers to pilot PC-Respiragene and PC-NMR interventions for feasibility
and determin...

## Key facts

- **NIH application ID:** 10005167
- **Project number:** 5U54CA163066-10
- **Recipient organization:** TENNESSEE STATE UNIVERSITY
- **Principal Investigator:** Rebecca Selove
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $79,778
- **Award type:** 5
- **Project period:** 2011-09-23 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005167

## Citation

> US National Institutes of Health, RePORTER application 10005167, Developing Personalized Smoking Treatment in the Southern Community Cohort Study (5U54CA163066-10). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10005167. Licensed CC0.

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