It is a matter of speculation whether the high prevalence of smoking among Hungarian
Roma (HR) is related to genetic, gene-environmental interactions or cultural factors.
Our aim is to compare the genetic susceptibility and possible effects of determinants
associated with smoking behaviours in the Hungarian general (HG) and Roma populations.
A complex health survey including three pillars (questionnaire, physical and laboratory
examinations) was carried out (NHG = 412 and NHR = 402). Risk allele frequencies of
ten single-nucleotide polymorphisms (SNPs) were compared, and their combined effect
was estimated by computing unweighted and weighted genetic risk scores (GRS, wGRS).
The effects of genetic and environmental factors were investigated in regression analyses
after confounders were introduced. Socio-economic status (SES) was calculated based
on the Kuppuswamy scale 2019. Risk allele frequencies of only four SNPs were found
to be different between populations (p < 0.01). Median values of GRS did not differ,
while the wGRS median was slightly higher among Roma individuals (5.2 vs. 4.9; p =
0.02). Roma individuals were more likely to be heavy smokers (ORmales = 2.05, 95%
CI [1.47–2.86]; ORfemales = 1.89, 95% CI [1.58–2.25]. Smokers have lower SES compared
to never smokers (SES βHR = −0.039, p = 0.023; βHG = −0.010, p = 0.049). An inverse
relationship was found between SES and smoking behaviours (p < 0.0001) and was found
to be a better predictor of smoking behaviours than genetic susceptibility. Our study
findings suggest that the high prevalence of smoking behaviours and nicotine-dependence
were not revealed to have a genetic susceptibility among HR individuals; therefore,
the highest efforts should be focused on targeting SES-related factors in the Roma
population. Strengths of the study: This is the first study carried out to investigate
and detect the most relevant factors and the possible genetic background of the extremely
high prevalence of smoking based in the Roma population. Limitations of the study:
No standard instrument has been used to assess the intensity of addiction to nicotine.
Because of some participants’ unwillingness to define themselves as Roma, the overall
HR population was not represented by the sample of this study.