FAQs

People smoke for many different reasons. Some smoke because of pressure from friends and relatives - others for relief of stress or simply from habit. When you want to stop smoking it makes sense to take all these reasons into account. In this way you can work out the best way to give up.

The NicoTest programme starts with a detailed series of questions to find out why you smoke. Then it uses a computer system to work out the best way for you to stop smoking. The computer gives you a ‘personalised’ programme to help you to quit. You can also log in to our 24-hour support service on the Internet that will guide and help you on your Flight to Freedom.

It is just possible that some differences in smoking habits could come from inherited changes in the way the body reacts to nicotine. Differences in our genes mean that some people break down nicotine more quickly than others. This means that the nicotine does not last very long in their bloodstream and may benefit from higher levels of NRT for the product to be effective. It is too early to say how much this matters when you are trying to stop smoking although it is know that heavier smokers often benefit from higher doses of NRT when they are trying to quit. Working this out will take clinical trials with thousands of people over many years. However if you are interested in finding out more about how your body works we tell you whether you have the common form of the gene that affects nicotine breakdown (CYP2A6).

We also let you know about another gene that may affect the way your brain reacts to nicotine (DRD2). Some scientists think that one form of the gene is more common in people who smoke regularly, although not all agree with this. It is again far too early to say what the impact of this gene is when you try to stop smoking. Some studies suggest that people with different forms of the gene do better with different treatments (bupropion Vs nicotine replacement). Although research is at a very early stage these results are being checked in further studies. There will be much more known about this in a few years time. But you might still find it interesting to know now what form of the gene you have. This might be a help if you are trying to understand what makes you smoke and work out how best to stop.

Cognitive Behavioural Therapy (CBT) has been shown to be highly effective in helping smokers get mentally and physically prepared for their quit attempt. The proven interactive online process helps reinforce the changes that they have made to their lifestyle and have been validated amongst North American quitters since 1999. Both the American Cancer Society and the Canadian Cancer Society endorse and utilise this approach.

We will mail you the NicoTest kit and you mail back your DNA sample. You also need to register in the Flight to Freedom and answer an online lifestyle questionnaire covering the particulars of your smoking habits. As soon as you register you will receive our 11-week motivational course to help you prepare for and maintain your quit.

Your Personalised Treatment Programme (PTP) will be issued when the DNA test is complete, the results are analysed and you have completed the Flight to Freedom up to Milestone 3.

Please note that your PTP will take about 10-14 days to process from the time you return your sample. In the meantime, we suggest you continue with the exercises in the Flight to Freedom as we will also need all the information you provide in Milestones 1 to 3 to issue your Personalised Treatment Programme.

Once we receive your DNA sample and you have completed all the exercises to Milestone 3, your test results are uploaded to your Flight to Freedom profile on the NicoTest website. Your results are combined with analysis of lifestyle issues that affect your smoking patterns. The Personalised Treatment Report (PTR) combines specific, appropriate treatment recommendations and a series of lifestyle pointers which we believe will maximise your chances of success.

Your PTR will also include a personalised coping plan to manage weight gain and stress as you adapt to your smoke-free lifestyle.

Each NicoTest™ kit contains a safe single-use finger-pricking device, an alcohol swab to clean the finger, and a sample pad to put the drop of blood on. This is then labelled and sent to us by post for analysis. You may feel a slight tingle when you do the test.

Everyone reacts differently to drugs and certain people may suffer adverse reactions. Personalised treatment empowers the patient by enabling them to be better informed in their choice of treatment by reducing this risk.

The cost of the NicoTest™ kit, Personalised Treatment Report and 24/7 support programme at £150 is equivalent to funding a pack-a-day habit for less than three weeks for an average smoker. E-vouchers are also available so people can give NicoTest™ as a gift.

At the moment NicoTest™ is primarily available from our website at www.nicotest.com and selected outlets We expect it will be available over the counter in pharmacies during 2005.

Our Personalised Treatment Report only recommends the optimum type of medication and dosage required. We will inform you of the the range of choices you may have in each product category. We are not associated with any manufacturers thereby enabling us to give you the most impartial advice.

Our behavioural support service is part of the 24/7 online package of ongoing help for quitters once the test has been purchased, to help you prepare, adapt and reinforce your quit process. It is available online at www.nicotest.com.

The NicoTest™ includes:

• The DNA analysis for genes that we believe are linked with smoking
• Your Personalised Treatment Report showing you the best way to stop smoking
• An extensive aftercare programme
• Your personal QuitMeter that you can download to your desktop to monitor progress
• The Nicotest Instant Messenger to enable you to 'chat' with your peers

The online support and aftercare includes:

• A 24/7 question and answer service moderated by trained qualified professionals professionals
• Peer group support, chat rooms and Instant Messenger
• Interactive training exercises
• Coping Plans to minimise Weight gain, for Fitness improvement and for Stress reduction
• Access to an extensive reference library
• Ongoing advice and programme modification
• An 11-week course of motivational emails

No. Unfortunately no one can guarantee success with any treatment method you chose. The fee covers the analysis of your lifestyle data plus the gene test. The best way to get your money back is to stop smoking! If you manage to achieve this you will be in a positive financial balance after three weeks.

It covers medicines such as nicotine patches, chewing gum, lozenges and different kinds of inhalers. The results of the NicoTest will also be a helpful guide for you to decide on whether to use non-nicotine therapy such as bupropion (more commonly known as Zyban) and possibly newer agents when they become available.

At the moment we are not able to supply the NicoTest™ to smokers under the age of 18. A significant proportion of smokers are under 18 and most adult smokers start before they are 15. People under the age of 18 should consult their GP or pharmacist for a special consultation.

NicoTest™ is marketed by g-Nostics Ltd, a company that is developing a range of tests that are used to show how people will respond to drug treatments (pharmacogenetics). This science is at an early stage. These tests will help people to understand more about how their body reacts to different treatments to minimise adverse reactions, which is the first step towards developing personalised medicine. Some of the g-Nostics founders were also involved in the original patents and various clinical trials for Nicotine Patch technology which was the first treatment shown to be effective for nicotine dependence.

By the time NicoTest™ was launched, £4million had been invested in the science behind it. Working capital was provided by a venture capital firm and the management team themselves.

Some of the founders of g-Nostics were involved in the original patents and various clinical trials for Nicotine patch technology. However, there are no current links between the pharmaceutical industry and g-Nostics. Your PTR will include unbiased and objective advice on which treatment to use - no specific brands are recommended. All recommendations conform with information published in the British National Formulary and the National Institute of Clinical Excellence (NICE).

We expect to be able to demonstrate the effectiveness of our approach to the DoH over the next year or so and we hope that the NicoTest™ will eventually be available to everyone through the NHS.

We have a non-smoking employment policy. However, due to our experience within the sector, all of us know smokers and we recognise how difficult it can be to quit without the right tools and resources.

The study of how our unique genetic make-up makes every individual respond differently to medicines. It helps Doctors and Pharmacists assess which drugs are most suitable for each person rather than using a 'Trial and Error' or 'One Size Fits All' approach. Pharmacogenetics enables us to reduce unnecessary side affects from medicines and ensure effective and safe treatment.

The NicoTest™ is one of the world's first commercial applications of pharmacogenetics made available to the general public.

Genetic and personal data are encrypted and kept separately and in such a way that they cannot be confused. Our storage and systems all conform to the highest current regulations.

We take the protection of personal information very seriously. Everything is done with the need for total confidentiality in mind. Our NicoTest™ analysis looks at a narrow selection of DNA to assess the nature of a person's addiction to nicotine. All genetic samples will be destroyed unless we have the patient's explicit permission to retain them. No data or information about patients will ever be sold to anyone else, without explicit permission.

Recognising the concerns of individuals we have invested in a robust and proven infrastructure. There are four types of data being processed by our systems: Financial, Genetic, Personal and Smoking-related data:

Financial data

We do not store any credit or debit card details other than the last four digits of the card number. Payments are processed in real time when a kit or a voucher is ordered and all card details are discarded immediately. All card details are transferred over an encrypted connection using standard 128-bit Secure Socket Layers (SSL). Financial data is shared only with card clearance companies and banks purely for the purpose of payment.

Genetic data

We store the minimum amount of genetic data, and only those aspects related specifically to smoking cessation. We do not store any other genetic information, such as susceptibility or predisposition to diseases. This information is encoded and has no use outside of research where consent is provided. Our DNA analysis laboratories deal with this information on an anonymous basis and cannot link it to any individual.

Personal data

We store customers' names, addresses, phone numbers and email addresses in order to be able to deliver kits to them and to be able to contact them. Personal data is not shared with any of our suppliers.

Smoking-related data

In order to be able to make treatment recommendations we ask customers for details such as age, height, weight and the number of cigarettes per day they smoke. This data is gathered for us by our Canadian partners and its use is covered by Canadian data protection regulations, which are as strong as the equivalent European regulations and are deemed as such by the EU. Our partners have no access to the genetic databank and may only undertake anonymised aggregate research relating to use of the software.

Combining these data sets

The only place that these data sets can be combined is on our own servers, which are hosted in a secure data centre and protected by the following security measures:

Physical security

All sensitive data is stored in a secure data centre in the UK. No unauthorised access is allowed to the building. The hosting facilities are also used by ‘Blue Chip’ companies. No sensitive data is stored in our offices.

Network security

Our web servers are located behind industry-standard firewalls, and the database servers where the information is stored are located on a separate network that is not publicly accessible and protected by another set of firewalls. All office use of the servers is over encrypted links and requires the use of multiple usernames and multiple passwords.

No. No information is ever passed onto anyone without the patient's explicit permission. NicoTest™ does not identify serious illness.

Yes. We believe we conform with all recommended guidelines published by the MHRA, Nuffield BioEthics Commission, Human Genetics Commission and other such bodies. Some of these bodies may act in an advisory capacity only. We are members of BIVDA and our products are, and will always, be CE Marked where appropriate. Both Diagnostic and Pharmaceutical companies are regulated by the Medicines and Health Regulatory Agency (MHRA) in the UK and in turn this ensures compliance with any EU initiatives issued.

We use ISO 9000 approved laboratories and the test kit components are all CE Marked.

The test is conducted by using a single-use lancet to form a spot of blood which can be transferred to the sample card. You may feel a slight tingle when you use the device. If you are not able to do this we recommend you take the kit to a pharmacist or your GP to help you administer the test. Whilst it would be theoretically possible to use DNA from a mouthwash or other source, the best quality DNA is obtained from your blood and this is in turn enables us to keep the cost down and minimise analysis time so we provide you with an efficient service.

Our corporate vision is to provide personalised treatment options across a number of therapeutic sectors. At the moment we are involved in a number of research projects that will lead to diagnostic tests that will improve the quality of health care for most of us in some way. Our next test will be available in 2005/6.

There are 109 scientific papers relevant to the science behind the Nicotest. The following selection of papers are published in scientific journals and available to the public.

1. 1. Noble EP, St. Jeor ST, Ritchie T, Syndulko K, St. Jeor SC, Fitch RJ, Brunner RL, Sparkes RS. D2 dopamine receptor gene and cigarette smoking: a reward gene? Med Hypotheses 1994;42(4):257-60.
2. 2. Walton R, Johnstone E, Munafo M, Neville M, Griffiths S. Genetic clues to the molecular basis of tobacco addiction and progress towards personalized therapy. Trends Mol Med 2001;7(2):70-6.
3. 3. Munafo M, Johnstone E, Murphy M, Walton R. New directions in the genetic mechanisms underlying nicotine addiction. Addict Biol 2001;6(2):109-117.
4. 4. Jonsson EG, Nothen MM, Grunhage F, Farde L, Nakashima Y, Propping P, Sedvall GC. Polymorphisms in the dopamine D2 receptor gene and their relationships to striatal dopamine receptor density of healthy volunteers. Mol Psychiatry 1999;4(3):290-6.
5. 5. Thompson J, Thomas N, Singleton A, Piggott M, Lloyd S, Perry EK, Morris CM, Perry RH, Ferrier IN, Court JA. D2 dopamine receptor gene (DRD2) Taq1 A polymorphism: reduced dopamine D2 receptor binding in the human striatum associated with the A1 allele. Pharmacogenetics 1997;7(6):479-84.
6. 6. Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, Cull JG, Comings DE. The D2 dopamine receptor gene as a determinant of reward deficiency syndrome. J R Soc Med 1996;89(7):396-400.
7. 7. Munafo MR, Clark TG, Moore LR, Payne E, Walton R, Flint J. Genetic polymorphisms and personality in healthy adults: a systematic review and meta-analysis. Mol Psychiatry 2003;8(5):471-84.
8. 8. Neville MJ, Johnstone EC, Walton RT. Identification and characterization of ANKK1: a novel kinase gene closely linked to DRD2 on chromosome band 11q23.1. Hum Mutat 2004;23(6):540-5.
9. 9. Comings DE, Ferry L, Bradshaw-Robinson S, Burchette R, Chiu C, Muhleman D. The dopamine D2 receptor (DRD2) gene: a genetic risk factor in smoking. Pharmacogenetics 1996;6(1):73-9.
10. 10. Munafo M, Clark T, Johnstone E, Murphy M, Walton R. The genetic basis for smoking behavior: a systematic review and meta-analysis. Nicotine Tob Res 2004;6(4):583-97.
11. 11. McKinney EF, Walton RT, Yudkin P, Fuller A, Haldar NA, Mant D, Murphy M, Welsh KI, Marshall SE. Association between polymorphisms in dopamine metabolic enzymes and tobacco consumption in smokers. Pharmacogenetics 2000;10(6):483-91.
12. 12. Johnstone EC, Yudkin PL, Hey K, Roberts SJ, Welch SJ, Murphy MF, Griffiths SE, Walton RT. Genetic variation in dopaminergic pathways and short-term effectiveness of the nicotine patch. Pharmacogenetics 2004;14(2):83-90.
13. 13. Lerman C, Shields PG, Wileyto EP, Audrain J, Hawk LH, Jr., Pinto A, Kucharski S, Krishnan S, Niaura R, Epstein LH. Effects of dopamine transporter and receptor polymorphisms on smoking cessation in a bupropion clinical trial. Health Psychol 2003;22(5):541-8.
14. 14. Swan GE, Valdes AM, Ring HZ, Khroyan TV, Jack LM, Ton CC, Curry SJ, McAfee T. Dopamine receptor DRD2 genotype and smoking cessation outcome following treatment with bupropion SR. Pharmacogenomics J 2004