Currently, efforts to reduce smoking rates have focused on the implementation of policies that restrict availability or use of cigarettes in public places. Anti-smoking policies directed at adolescents address onset of cigarette use, while emphasizing the role of immediate social influences and refusal skills, which have been shown to reduce initiation by 30% (114). However, it is possible that these policies may only be effective for those who are not genetically susceptible to smoking. Furthermore, although restrictions on smoking in public places, anti-tobacco ads, and increased costs of purchasing cigarettes through excise taxes have also aided smokers in quitting, there remain concerns that policies have focused too heavily on implementing social restrictions on cigarette use, while doing less to help genetically vulnerable smokers quit (96). To address this gap in the literature and further reduce smoking rates, greater focus needs to be placed on determining the extent to which individual differences are due to genes, environmental factors, or their interaction. Gene-environment interaction studies may help us to better understand how prevention and intervention efforts can be tailored to genotypes under different environmental contexts at the level of family, school, neighborhood, and public policy.
