Can genetic risk information for age-related macular degeneration influence motivation to stop smoking? A pilot study

Abstract

Aims Smoking can increase the risk of macular degeneration and this is more than additive if a person also has a genetic risk. The purpose of this study was to examine whether knowledge of genetic risk for age-related macular degeneration (AMD) could influence motivation to quit smoking. Methods A questionnaire-based study of hypothetical case scenarios given to 49 smokers without AMD. Participants were randomly allocated to a generic risk, high genetic risk, or low genetic risk of developing AMD scenario. Results Forty-seven percent knew of the link between smoking and eye disease. In all, 76%, 67%, and 46% for the high risk, generic, and low risk groups, respectively, would rethink quitting (P for trend ¼ 0.082). In all, 67%, 40%, and 38.5%, respectively, would be likely, very likely, or would definitely quit in the following month (P for trend ¼ 0.023). Few participants (o16% of any group) were very likely to or would definitely attend a quit smoking session with no difference across groups. In all, 75.5% of participants would consider taking a genetic test for AMD. Conclusion In this pilot study, a trend was seen for the group given high genetic risk information to be more likely to quit than the generic or low genetic risk groups. Participants were willing to take a genetic test but further work is needed to address the cost benefits of routine genetic testing for risk of AMD. More generic risk information should be given to the public, and health warnings on cigarette packets that 'smoking causes blindness' is a good way to achieve this.

Risk Alleles in CFH and ARMS2 and the Long-term Natural History of Age-Related Macular Degeneration

“…Candidate SNPs from both CFH and ARMS2 have consistently shown stronger associations with both exudative AMD and GA than with signs of early AMD. 1–5,10–16,18–22,49–51,53–67 Our results are consistent with cross-sectional findings from the Blue Mountains Eye Study, the Rotterdam Study and the ALIENOR study where persons who were homozygous for the CFH variant had increased odds ranging from 1.2 to 2.4 for early AMD compared to no AMD. 54,55,64 In addition, in the Rotterdam Study, the association became stronger with increasing severity of early AMD.…”

“…For example, data from a pilot study showed that smokers reported they would be more likely to quit smoking if told they were at high genetic risk of developing late AMD. 51 However, in the BDES, smoking status has not proven to be a risk factor for the cumulative incidence of late AMD, 52 and to date, it has not been demonstrated that interventions to alter behaviors (eg, change in diet, smoking cessation) affect the incidence of late AMD.…”

Smoking and Age-Related Macular Degeneration: Review and Update

“…This is even more relevant in smoking subjects, as a genetic high-risk profile might influence their motivation to quit smoking [106]. …”

How Do Patients Respond to Genetic Testing for Age-related Macular Degeneration?

“… 16 , 17 A pilot study in 49 smokers demonstrated that people given high genetic risk information were more likely to quit smoking than generic or low genetic risk groups. 18 …”