Nicottine is widely present in cigarettes

Genes influence nicotine dependence tendency

BioCertica Content Team

Written by: Jonine Moller, M.Sc. in Sports Science

Cigarette smoking is highly addictive due to the nicotine in tobacco. Cigarettes account for the largest proportion of tobacco use. Even though the adverse effects are widely known, smoking cessation remains a significant challenge for many. This is due to the strength of the physical nicotine addiction [1].

The demand that smoking places on the health care system and the costs involved are massive. Smoking is responsible for 7% of the total costs of health care in the United States [1]. It is also the leading cause of death due to lung cancer [2].

Cigarette smoking increases your risk of all-cause death [3]. Of course, cancers, especially lung cancer, can be caused by smoking [1]. It is also strongly associated with all cardiovascular diseases and increases in related risk factors. Cardiovascular diseases include peripheral artery disease, coronary heart disease, heart attack, stroke, etc. [4, 5].

Smoking increases the risk for cardiovascular disease by impacting many factors. Cigarette smoking may cause or increase [6, 7, 8, 9]:

  •       Inflammation and oxidative stress
  •       Constriction of blood vessels
  •       Arterial stiffness
  •       Damage to the blood vessels
  •       Increased platelet activation leading to the formation of blood clots
  •       Insulin resistance

A slightly less famous effect of smoking is that it negatively alters your gut microbiota. Simply put, your gut microbiota is bacteria in your intestines. This bacteria is good and needed, and the composition thereof impacts your metabolic health [10].

We must mention the effect that smoking has during pregnancy. Smoking during any trimester increases the risk for preterm birth. Even if the mother smoked three months before falling pregnant, the risk was higher, although not as high [11].

Smoking also increases the risk of having difficulty conceiving. Smoking during pregnancy may cause an array of adverse outcomes for the child. Birth defects, psychiatric diseases, and childhood cancers are among the risks. The sooner the mother quits smoking, the smaller the risk [12].

It is concerning how many young people are using tobacco products, especially e-cigarettes. Nicotine can harm the developing brain in this population. It may open the door for the use of other substances and reduce impulse control. Attention and cognition deficits may occur, and mood disorders can be caused [13].

E-cigarettes are advertised to help you quit smoking. Manufacturers may claim they are suitable for this purpose due to being less harmful [14]. Be careful of blindly believing such claims, though. False advertising concerning the safety of e-cigarettes could be a factor contributing to the increase in their use.

E-cigarette use is serious enough that the US department of health and human services surgeon general has issued a report on it. The report focuses on the youth and young adults. This group has been showing a massive rise in the smoking of these cigarettes [13].

First of all, evidence shows smoking e-cigarettes don’t contribute to aiding smoking cessation. Neither do e-cigarettes prevent cigarette smoking. The converse is, in fact, more accurate. E-cigarettes greatly increase the likelihood of future cigarette smoking [15, 16].

Secondly, they may not be as harmless as many believe. Like regular cigarettes, e-cigarettes also increase platelet aggregation [9]. Thus, they also increase the risk for blood clots to form, which can lead to a heart attack or stroke. 

Nicotine in itself may be an initiator of the atherosclerotic process [13]. E-cigarettes also cause stiffening of the major blood vessels and increases in blood pressure. This is evident even among young smokers [17]. 

The dangers of smoking and tobacco use should encourage quitting. Unfortunately, due to the addictive nature of nicotine, quitting can be extremely difficult. Thus, the importance of preventing rather than curing cannot be any more applicable. 

Prevention in the context of smoking obviously means ever starting to smoke. Never starting is much better than trying to quit later on. This is true especially considering the risks and how difficult it is to quit. 

It is reported that only 3% - 5% of smokers that try to quit are permanently successful [1]. Only 10% last longer than six months before a relapse. Addiction treatment helps but is also very far from full proof [18].

To prevent nicotine dependence, understanding the development thereof is vital. Knowing how you become addicted may help you to avoid the risk. Denying the possibility that you may become addicted to nicotine could make it “easier” to experiment with tobacco use.

Nicotine dependence has a genetic factor. Specific common gene variants place you at a higher risk of becoming addicted to nicotine [19]. In accordance, the heritability of nicotine dependence is at least 50% [1, 2].

Nicotine dependence can be quantified using the answers to a couple of questions. The number of cigarettes someone smokes per day is a common way to quantify dependence. How soon after waking up the first cigarette is smoked is another measure [19].

The latter strongly predicts how easily someone will be able to quit smoking. It also predicts the likelihood of relapse. Among smokers, the degree of dependency correlates with specific genes [19].

Predisposing genes influence several aspects leading to nicotine addiction. These include having more difficulty quitting and experiencing more severe withdrawal symptoms [18].

Besides the genetic tendency to become dependent on nicotine, environmental factors also play a prominent role [1, 19]. The following environmental factors contribute to the likelihood to start smoking [15, 18, 20]:

  •       Being single vs. married
  •       Living in urban vs. rural settings
  •       Socioeconomic status
  •       Religion
  •       Parental monitoring
  •       Parental education and smoking status
  •       Closeness of parents
  •       Impulsivity
  •       Depression or anxiety
  •       Peer influences

A protective environment reduces the likelihood of starting to smoke. Advantaged socioeconomic backgrounds may, however, increase the likelihood of smoking [18]. Peer influence is one of the most substantial environmental factors to start using tobacco in any way [20].

If you have predisposing genes, even a very low frequency of tobacco use can lead to dependency [18]. Thus, knowing your genetic predisposition may be necessary to ensure you don’t place yourself at risk of addiction.

BioCertica tests for your inclination to nicotine dependence as a part of the mental health product. Prevent addiction by knowing you have to stay clear of any type of smoking or tobacco use. Or get professional help to quit if you are genetically inclined to higher dependence. Your willpower may not be enough to overcome physical dependence [18].


[1] Li, M. D. (2006). The genetics of nicotine dependence. Current Psychiatry Reports, 8(2), 158–164.

[2] Ray, R., Schnoll, R. A., & Lerman, C. (2009). Nicotine dependence: Biology, behavior, and treatment. Annual Review of Medicine, 60, 247–260.

[3] Ge, Z., Hao, Y., Cao, J., Li, J., Chen, J., Huang, J., Wu, X., & Gu, D. (2012). Does cigarette smoking exacerbate the effect of blood pressure on the risk of cardiovascular and all-cause mortality among hypertensive patients? Journal of Hypertension, 30(12), 2307–2313.

[4] Ambrose, J. A., & Barua, R. S. (2004). The pathophysiology of cigarette smoking and cardiovascular disease: An update. Journal of the American College of Cardiology, 43(10), 1731–1737.

[5] Ding, N., Sang, Y., Chen, J., Ballew, S. H., Kalbaugh, C. A., Salameh, M. J., Blaha, M. J., Allison, M., Heiss, G., Selvin, E., Coresh, J., & Matsushita, K. (2019). Cigarette Smoking, Smoking Cessation, and Long-Term Risk of 3 Major Atherosclerotic Diseases. Journal of the American College of Cardiology, 74(4), 498–507.

[6] Facchini, F. S., Hollenbeck, C. B., Jeppesen, J., Ida Chen, Y. D., & Reaven, G. M. (1992). Insulin resistance and cigarette smoking. The Lancet, 339(8802), 1128–1130.

[7] Gumus, A. (2013). The Effect of Cigarette Smoking on Blood Pressure and Hypertension. Advances in Bioscience and Clinical Medicine, 1(1), 6–11.

[8] Ikonomidis, I., Vlastos, D., Kourea, K., Kostelli, G., Varoudi, M., Pavlidis, G., Efentakis, P., Triantafyllidi, H., Parissis, J., Andreadou, I., Iliodromitis, E., & Lekakis, J. (2018). Electronic cigarette smoking increases arterial stiffness and oxidative stress to a lesser extent than a single conventional cigarette. Circulation, 137(3), 303–306.

[9] Nocella, C., Biondi-Zoccai, G., Sciarretta, S., Peruzzi, M., Pagano, F., Loffredo, L., Pignatelli, P., Bullen, C., Frati, G., & Carnevale, R. (2018). Impact of Tobacco Versus Electronic Cigarette Smoking on Platelet Function. American Journal of Cardiology, 122(9), 1477–1481.

[10]  Lee, S. H., Yun, Y., Kim, S. J., Lee, E. J., Chang, Y., Ryu, S., Shin, H., Kim, H. L., Kim, H. N., & Lee, J. H. (2018). Association between cigarette smoking status and composition of gut microbiota: Population-based cross-sectional study. Journal of Clinical Medicine, 7(9).

[11]  Soneji, S., & Beltrán-Sánchez, H. (2019). Association of Maternal Cigarette Smoking and Smoking Cessation with Preterm Birth. JAMA Network Open, 2(4), 1–14.

[12]  Cnattingius, S. (2004). The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine and Tobacco Research, 6(SUPPL. 2).

[13]  U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1–298.

[14]  Using e-cigarettes to stop smoking. (2019).

[15]  Kim, S., & Selya, A. S. (2020). The Relationship between Electronic Cigarette Use and Conventional Cigarette Smoking Is Largely Attributable to Shared Risk Factors. Nicotine and Tobacco Research, 22(7), 1123–1130.

[16]  Primack, B. A., Shensa, A., Sidani, J. E., Hoffman, B. L., Soneji, S., Sargent, J. D., Hoffman, R. M., & Fine, M. J. (2018). Initiation of Traditional Cigarette Smoking after Electronic Cigarette Use Among Tobacco-Naïve US Young Adults. American Journal of Medicine, 131(4), 443.e1-443.e9.

[17]  Vlachopoulos, C., Ioakeimidis, N., Abdelrasoul, M., Terentes-Printzios, D., Georgakopoulos, C., Pietri, P., Stefanadis, C., & Tousoulis, D. (2016). Electronic Cigarette Smoking Increases Aortic Stiffness and Blood Pressure in Young Smokers. Journal of the American College of Cardiology, 67(23), 2802–2803.

[18]  Lessov-Schlaggar, C. N., Pergadia, M. L., Khroyan, T. V., & Swan, G. E. (2008). Genetics of nicotine dependence and pharmacotherapy. Biochemical Pharmacology, 75(1), 178–195.

[19]  Chen, J., Loukola, A., Gillespie, N. A., Peterson, R., Jia, P., Riley, B., Maes, H., Dick, D. M., Kendler, K. S., Damaj, M. I., Miles, M. F., Zhao, Z., Li, M. D., Vink, J. M., Minica, C. C., Willemsen, G., Boomsma, D. I., Qaiser, B., Madden, P. A. F., … Chen, X. (2020). Genome-Wide Meta-Analyses of FTND and TTFC Phenotypes. Nicotine and Tobacco Research, 22(6), 900–909.

[20]  Kandel, D. B., Hu, M. C., Griesler, P. C., & Schaffran, C. (2007). On the development of nicotine dependence in adolescence. Drug and Alcohol Dependence, 91(1), 26–39.

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