Introduction: Direct-to-consumer personal genomic testing has the potential to influence health behaviors, including smoking. Critics of this testing highlight limited evidence to support positive behavioral benefits and caution that genomic results may provide false reassurance, leading to unhealthy behaviors. This study investigates interest in genetic risks of smoking-related diseases and changes in smoking behaviors among genomic testing consumers. Methods: From 2012 to 2013, a longitudinal series of web surveys was conducted. A total of 1464 customers of 23andMe and Pathway Genomics completed a survey prior to viewing genomic test results, of which 1002 participants provided data on smoking behaviors 6 months after receiving results. Results: At baseline, 64% of participants were never smokers, 29% were former smokers, and 7% were current smokers. Most baseline current smokers were very interested in genetic risk results for lung cancer (65%) and heart disease (72%). For lung cancer, this interest was significantly greater than former (50% very interested) and never smokers (37% very interested) (p < .0001). Even though participants were interested in smoking-related disease genetic risks, 96% reported the same smoking status at baseline and 6-month follow-up. Importantly, only 1% (n = 13/916) of former and never smokers became current smokers at 6 months and 22% (n = 14/64) of current smokers reported quitting. Conclusions: Overall, smokers show a high level of interest in genetic risks of smoking-related illnesses. The experience of receiving direct-to-consumer genomic health risks does not appear to have obvious harms related to smoking behaviors, with some potential benefits. Implications: In the setting of ongoing controversy surrounding direct-to-consumer genomic testing, this study provides evidence that consumers are interested in genetic risk results of smokingrelated diseases. Receiving genomic testing results does not lead to smoking initiation among never smokers or reinitiation among former smokers and may be associated with a higher quit rate among current smokers at 6-month follow-up than the general population. These findings ease concerns that direct-to-consumer genomic testing could lead to false reassurance and unhealthy behaviors related to smoking.
Bibliographical noteFunding Information:
This work was supported by the National Human Genome Research Institute (R01HG005092 to RCG and JSR; U01HG006500, U19HD077671, and R01HG002213 to RCG); the National Institute of Drug Abuse (R01DA036583 to LJB; and K08DA032680 to SH); the National Cancer Institute (P30CA091842 supporting LJB); the National Institute on Alcohol Abuse and Alcoholism (F30AA023685 to EO); the National Institute of General Medical Sciences (T32GM07200 supporting EO); the National Center for Advancing Translational Sciences (UL1TR000448 and TL1TR000449 supporting EO); DAC is funded by a Canadian Institutes of Health Research Postdoctoral Fellowship award and the Michael G. DeGroote Postdoctoral Fellowship from McMaster University. Members of the PGen Study at the time of publication are as follows: Kurt D. Christensen, Robert C. Green, Margaret H. Helm, Joel B. Krier, Lisa S. Lehmann, Erica Schonman (Harvard Medical School, Brigham and Women's Hospital); Peter Kraft (Harvard School of Public Health); Mick P. Couper, J. Scott Roberts, Wendy R. Uhlmann (University of Michigan); Lan Q Le, Mack T. Ruffin IV, Jenny Ostergren (University of Michigan School of Public Health); Deanna Alexis Carere (McMaster University); Amy K. Kiefer, Joanna L. Mountain (23andMe); Glenn D. Braunstein (Pathway Genomics); Scott D. Crawford (Survey Sciences Group); Clara A. Chen, L. Adrienne Cupples, Catharine Wang (Boston University School of Public Health); Stacy W. Gray (Dana-Farber Cancer Institute); Barbara A. Koenig (University of California San Francisco); Kimberly Kaphingst (University of Utah); Sarah Gollust (University of Minnesota).