The impact of learning of a genetic predisposition to nicotine dependence: an analogue study: Table 1

Abstract

Objectives: To examine the consequences of informing smokers of a genetic predisposition to nicotine dependence and of providing treatment efficacy information tailored to genetic status. Design: Analogue study using four vignettes; 2 (genetic status) × 2 (whether treatment efficacy information provided) between subjects design. Participants: 269 British adult smokers. Outcome measures: Preferred cessation methods and perceived control over quitting. Results: Gene positive participants were significantly more likely to choose the cessation method described as effective for their genetic status, but significantly less likely to choose to use their own willpower. Providing tailored treatment information did not alter these effects. Perceived control was not significantly affected by either genetic status or information provision. Conclusions: Learning of a genetic predisposition to nicotine dependence may increase desire for effective cessation methods, but may undermine the perceived importance of willpower in stopping smoking. There is growing interest in identifying genetic markers that predict a heightened risk of nicotine dependence.1 2 A recent review suggested that the most likely benefit of this research would be an improvement in smoking cessation rates, achieved by tailoring cessation interventions to a smoker's genetic profile.1 However, it is important to consider whether telling smokers that they are genetically predisposed to nicotine dependence will make them believe that their nicotine dependence is intractable. Research into reactions to genetic testing has largely focused on testing predictive of disease risk.3 Two studies have examined the impact on smokers' quitting behaviours of learning of a genetic vulnerability to lung cancer. The provision of high risk information did not increase cessation rates. [4][5][6] It is possible that genetic testing predictive of cessation treatment response may more effectively promote smoking cessation than genetic risk information predictive of disease susceptibility. Genetic risks are sometimes seen as immutable and may engender a sense of fatalism.7 Given that perceived control is an important predictor of motivation for, and actual, addictive behaviour change, 8 learning one has a genetic predisposition to nicotine dependence could adversely affect quitting.Clinicians also need to know how the provision of information regarding genetic predisposition to dependence will affect smokers' choice of cessation methods. An individual's perception of a health problem, including its causes, influences their coping actions.9 Telling individuals that they have a genetic predisposition to nicotine dependence should influence actions taken to stop smoking. Clinicians can take advantage of this relation between perceived causes and actions by providing information about cessation methods particularly suited to those with a genetic predisposition to nicotine dependence.As research on this topic is at an early stage, smokers are not yet being offered information on their g...

Behavioral Consequences of Testing for Obesity Risk

“…Although genetic testing for obesity risk is not yet available, genetic research in obesity may lead to susceptibility testing in the future (5). Consequently, we utilized a common vignette paradigm that asks individuals to consider different hypothetical scenarios for testing (6). We used the Theory of Planned Behavior as our conceptual model (7).…”

A Preliminary Exploration of College Smokers’ Reactions to Nicotine Dependence Genetic Susceptibility Feedback

“…8 For example, informing young smokers they have a genetic predisposition to nicotine dependence may undermine their efficacy to quit and amount of effort spent on planning and trying to quit. 8 Consistent with this view, using hypothetical vignettes, smokers informed they had a genetic variant related to increased nicotine dependence reported less use of willpower as a means to quit, 9 although perceived control over their ability to quit was not influenced by the feedback. In another study, adult smokers who attributed their smoking to genetic causes reported lower control over smoking, although such attribution did not predict cessation success.…”

A cost-effectiveness analysis of genetic testing of the DRD2 Taq1A polymorphism to aid treatment choice for smoking cessation

“…Also, offering treatment advice on the basis of a genetic test to an individual who subsequently fails to stop smoking may result in reduced motivation to make further attempts (Munafò, Lerman, Niaura, Shields, & Swan, 2005;. Although no data currently exist to test this possibility directly, analogue studies suggest genetic feedback may decrease the perceived value of will-power in a cessation attempt (Wright et al, 2003).…”

“…Indeed, recommending bupropion on the basis of the results of a genetic test may encourage patients who would otherwise be reluctant to use this pharmacotherapy to do so. This possibility will require independent testing, possibly using analogue methods (Wright, Weinman, & Marteau, 2003).…”