The analysis may help ???identify individuals in need of additional resources and assist in efforts to more effectively target the next generation of tobacco control strategies,??? say authors led by Lila J. Finney Rutten of the National Cancer Institute.

The study, in the current issue of American Journal of Health Behavior, found those who had never smoked and sustained quitters - those who had not smoked for at least a year - were more likely to have health insurance and a usual source of care than current smokers. They were also more likely to have seen a health-care provider within the last 12 months and reported higher levels of trust in the information they received.

In addition, nonsmokers reported better health and fewer symptoms of depression than current smokers. ???Active depressive symptoms may impact individuals?? willingness [or] ability to be effectively engaged in their health care,??? say the authors. ???Our results suggest that additional efforts to identify and follow up with smokers experiencing depression may be especially needed.???

The authors analyzed data from the 2003 Health Information National Trends Survey. These nationally representative data are collected every 2 years to assess the public??s need for, access to and use of cancer-related information. The study comprised 1,246 current smokers, 1,502 sustained quitters and 3,277 people who had never smoked.

???Taken as a whole, these results point to a constellation of individual and system factors that may impact smokers?? ability to successfully sustain smoking cessation,??? say the authors.

Smoking kills more people each year than alcohol, AIDS, car accidents, illegal drugs, murders, and suicides combined, according to the Campaign for Tobacco-Free Kids.


Initially, Harish Prasad, Ph.D., a senior scientist in the Blakely lab, examined 10 different SERT variants to see how well they functioned. With the exception of one variant common to both studies, most of these variants had not been previously linked to any clinical conditions.

While the variant SERTs could perform their basic function of 'vacuuming' up excess serotonin, intracellular signaling pathways that normally fine-tune SERT activity were unable to control five of the 10 mutant SERT proteins examined.

"We were stunned because the cell just can't 'talk' to these SERT proteins in a normal way," Blakely said. "Although it's impossible to extrapolate from a molecule to a person," he said, "it is striking that these mutations, which do not allow proper communication with SERT, show up in a disorder fraught with communication problems."

Interestingly, drugs that target these intracellular pathways, the p38 MAPK and the PKG pathways, have been investigated in a number of disorders unrelated to autism, such as inflammation and cancer. Targeting these pathways might offer a new alternative for treating autism with medications.

"This is a potential therapeutic area that we hadn't envisioned before," Blakely said.

Based on these findings, Blakely and Sutcliffe predict that there will one day be a way to test autistic children for these gene variants, similar to the testing done for cystic fibrosis, a disease linked to a single gene but triggered by many different mutations.

"Autism has such a high genetic risk, but these new findings suggest that there may be many variants of individual genes at work," Blakely said.

With such genetic testing, said Sutcliffe, "you might be able to predict which kids would respond positively to particular SSRI medications."

"We now have concrete evidence in our families that the SERT gene is a risk factor in autism," Blakely said. "Perhaps more importantly, we also have new pathways that could have some therapeutic end points, and that, to us, is really good news."