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To the Editor: The Commentary by Drs Carlsten and Burke¹ fails to mount a compelling argument to curtail research funding aimed at identification of gene variants relating to smoking or smoking-attributable outcomes. Of 10 311 active National Institutes of Health grants and contracts related to cancer research, only 24 (0.23%) investigate genetic factors in tobacco use.² Because tobacco use is the single largest preventable cause of premature death and accounts for approximately $167 billion annually in health-related costs ($75 billion) and work-related costs ($92 billion),³ this modest investment could transform medicine and public health.

The number of examples in medicine in which genetic analyses have identified completely novel mechanisms of disease is growing. It is perplexing that Carlsten and Burke focus almost exclusively on whether genetic testing has a role in prevention or treatment of nicotine dependence (we agree that there is none evident yet). The authors' desire for results that . . . [Full Text of this Article]

Laura Jean Bierut, MD
Department of Psychiatry
Washington University School of Medicine
St Louis, Mo

Joseph F. Cubells, MD, PhD
Department of Human Genetics
Emory University School of Medicine
Atlanta, Ga

William G. Iacono, PhD
Department of Psychology
University of Minnesota
Minneapolis

Ming D. Li, PhD
Department of Psychiatry
University of Virginia
Charlottesville

Pamela A. F. Madden, PhD
Department of Psychiatry
Washington University School of Medicine

Elliot C. Nelson, MD
Department of Psychiatry
Washington University in St Louis
St Louis, Mo

Jonathan D. Pollock, PhD; Joni L. Rutter, PhD
Division of Basic Neuroscience and Behavioral Research
National Institute on Drug Abuse
Bethesda, Md

Gary E. Swan, PhD
gary.swan@sri.com
Center for Health Sciences
SRI International
Menlo Park, Calif

Michael Vanyukov, PhD
Department of Pharmaceutical Sciences
University of Pittsburgh
Pittsburgh, Pa

RELATED LETTER

Genetic Research and Smoking Behavior—Reply
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Potential for Genetics to Promote Public Health: Genetics Research on Smoking Suggests Caution About Expectations
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