From the Departments of Pharmacology, Medicine, and Psychiatry, Centre for Research in Women's Health, Women's College Hospital, University of Toronto, and Addiction Research Foundation, Toronto, Ontario.
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.
Sellers EM. Pharmacogenetics and Ethnoracial Differences in Smoking. JAMA. 1998;280(2):179-180. doi:10.1001/jama.280.2.179