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A population-based twin study in women of smoking initiation and nicotine dependence

Published online by Cambridge University Press:  01 March 1999

K. S. KENDLER ,
M. C. NEALE ,
P. SULLIVAN ,
L. A. COREY ,
C. O. GARDNER  and
C. A. PRESCOTT
K. S. KENDLER
Affiliation:
Departments of Psychiatry and Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Medical College of Virginia Commonwealth University, Richmond, VA, USA
M. C. NEALE
Affiliation:
Departments of Psychiatry and Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Medical College of Virginia Commonwealth University, Richmond, VA, USA
P. SULLIVAN
Affiliation:
Departments of Psychiatry and Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Medical College of Virginia Commonwealth University, Richmond, VA, USA
L. A. COREY
Affiliation:
Departments of Psychiatry and Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Medical College of Virginia Commonwealth University, Richmond, VA, USA
C. O. GARDNER
Affiliation:
Departments of Psychiatry and Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Medical College of Virginia Commonwealth University, Richmond, VA, USA
C. A. PRESCOTT
Affiliation:
Departments of Psychiatry and Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Medical College of Virginia Commonwealth University, Richmond, VA, USA
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Abstract

Background. The development of drug dependence requires prior initiation. What is the relationship between the risk factors for initiation and dependence?

Methods. Using smoking as a model addiction, we assessed smoking initiation (SI) and nicotine dependence (ND) by personal interview in 1898 female twins from the population-based Virginia Twin Registry. We developed a twin structural equation model that estimates the correlation between the liability to SI and the liability to ND, given SI.

Results. The liabilities to SI and ND were substantially correlated but not identical. Heritable factors played an important aetiological role in SI and in ND. While the majority of genetic risk factors for ND were shared with SI, a distinct set of familial factors, which were probably partly genetic, solely influenced the risk for ND. SI was associated with low levels of education and religiosity, high levels of neuroticism and extroversion and a history of a wide range of psychiatric disorders. ND was associated with low levels of education, extroversion, mastery, and self-esteem, high levels of neuroticism and dependency and a history of mood and alcohol use disorders.

Conclusions. The aetiological factors that influence SI and ND, while overlapping, are not perfectly correlated. One set of genetic factors plays a significant aetiological role in both SI and ND, while another set of familial factors, probably in part genetic, solely influences ND. Some risk factors for SI and ND impact similarly on both stages, some act at only one stage and others impact differently and even in opposite directions at the two stages. The pathway to substance dependence is complex and involves multiple genetic and environmental risk factors.

Type
Research Article
Information
Psychological Medicine , Volume 29 , Issue 2 , March 1999 , pp. 299 - 308
Copyright
© 1999 Cambridge University Press

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