Anticipated Motivation for Genetic Testing among Smokers, Nonsmokers, and Former Smokers: An Exploratory Qualitative Study of Decision Making

Abstract

Objectives: This qualitative study explores the public's interest in genetic testing related to cigarette smoking, comparing the public's motivations with researchers' intentions for this technology. Methods: Adult nonsmokers (n = 463), former smokers (n = 163), and current smokers (n = 129) completed an online survey. Within a hypothetical scenario, respondents decided whether they desired genetic testing related to smoking and explained their decision making. A non-parametric Kruskal-Wallis test was used to compare the interest in genetic testing by smoking history group. Inductive content analysis was used to investigate respondents' explanations for their testing decisions. Results: Most nonsmokers (64%) and former smokers (58%) did not want genetic testing. While most current daily smokers were interested in testing (56%), most current occasional smokers were not (52%). Respondents' decision-making explanations were categorized into 3 major themes: Causality, Relevancy and Utility (e.g. personal benefits or harms). The use of causality, relevancy and utility explanations varied by smoking history. Notable perceived benefits of testing included recreation and altruism. Notable perceived harms included fear of fatalistic thoughts and concern about genetic discrimination. Conclusions: Interest in genetic testing was highest among current daily smokers, despite potential utility in other groups. Although respondents' motivations for testing paralleled researchers' intentions of tailoring smoking cessation therapies and increasing motivation to quit or abstain, respondents also raised alternative motivations and fears that healthcare providers would need to address.

Most Current Smokers Desire Genetic Susceptibility Testing and Genetically-Efficacious Medication

“…The finding that 84.8% of current daily smokers reported a high interest in receiving genetic susceptibility testing results is higher than the previously reported value of 56% (Giordimaina et al 2014). This may be due to several factors, including possible historical changes in the public perception of genetic testing and/or selection bias in that both the observational study and the clinical trial included actual genetic testing.…”

“…This may be due to several factors, including possible historical changes in the public perception of genetic testing and/or selection bias in that both the observational study and the clinical trial included actual genetic testing. Although neither the observational study nor the clinical trial disclosed genetic susceptibility results to participants, their status as inperson genetic studies on nicotine dependence likely distinguishes them from the prior online study in which 75% of current smokers reported finding genetic susceptibility testing to be personally irrelevant (Giordimaina et al 2014).…”

“…Among current daily smokers, genetic testing for susceptibility to developing nicotine dependence is also fairly well-received, with Giordimaina et al (2014) finding that 56% reported a desire for testing. As with genetic susceptibility testing for smoking-related disease, initial findings indicate positive effects of susceptibility testing for nicotine dependence.…”

Genetic feedback for psychiatric conditions: Where are we now and where are we going

“…Both positive family history (DeLisi & Bertisch, 2006;Wilde et al, 2010) and personal history (Giordimaina, Sheldon, & Petty, 2014;Laegsgaard et al, 2009) of a psychiatric condition are associated with increased interest in a genetic test that would determine individual risk (DeLisi & Bertisch, 2006;Giordimaina et al, 2014;Laegsgaard et al, 2009;Wilde et al, 2010). For example, 83.3% of family members of individuals with schizophrenia reported having interest in genetic testing if such a test became available in the future (DeLisi & Bertisch, 2006), and 83% of individuals who had a personal history of depression, anxiety, schizophrenia, or bipolar disorder were interested in psychiatric genetic testing (Laegsgaard et al, 2009).…”

“…For example, 83.3% of family members of individuals with schizophrenia reported having interest in genetic testing if such a test became available in the future (DeLisi & Bertisch, 2006), and 83% of individuals who had a personal history of depression, anxiety, schizophrenia, or bipolar disorder were interested in psychiatric genetic testing (Laegsgaard et al, 2009). Current daily smokers were more interested in genetic testing for a gene related to smoking than nonsmokers or former smokers (Giordimaina et al, 2014), suggesting that there may be differences in interest between individuals with and without a current personal history of the condition.…”