Impact of Genetic Notification on Smoking Cessation: Systematic Review and Pooled-Analysis

Viron, Sylviane de; Heyden, Johan Van der; Ambrosino, Elena; Arbyn, Marc; Brand, Angela; Oyen, Herman Van

doi:10.1371/journal.pone.0040230

Cited by 21 publications

(27 citation statements)

References 33 publications

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“…The present review indicated that improvements to smoking habits were promising in the short-term. This finding was consistent with that of a previously published systematic review of the impact of genetic notification on smoking cessation [66]. …”

Section: Discussionsupporting

confidence: 93%

A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory?

et al. 2018

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Background: Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. Purpose: This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provided to participants while aiming to determine whether or not genetic testing facilitates changes in lifestyle habits. This review is timely in light of a recently published “call-to-action” paper, highlighting the need to incorporate the TPB into personalized healthcare behaviour change research. Methods: Three bibliographic databases, one key website, and article reference lists were searched for relevant primary research articles. The PRISMA Flow Diagram and PRISMA Checklist were used to guide the search strategy and manuscript preparation. Out of 32,783 titles retrieved, 26 studies met the inclusion criteria. Three quality assessments were conducted and included: (1) risk of bias, (2) quality of genetic interventions, and (3) consideration of theoretical underpinnings – primarily the TPB. Results: Risk of bias in studies was overall rated to be “fair.” Consideration of the TPB was “poor,” with no study making reference to this validated theory. While some studies (n = 11; 42%) made reference to other behaviour change theories, these theories were generally mentioned briefly, and were not thoroughly incorporated into the study design or analyses. The genetic interventions provided to participants were overall of “poor” quality. However, a separate analysis of studies using controlled intervention research methods demonstrated the use of higher-quality genetic interventions (overall rated to be “fair”). The provision of actionable recommendations informed by genetic testing was more likely to facilitate behaviour change than the provision of genetic information without actionable lifestyle recommendations. Several studies of good quality demonstrated changes in lifestyle habits arising from the provision of genetic interventions. The most promising lifestyle changes were changes in nutrition. Conclusions: It is possible to facilitate behaviour change using genetic testing as the catalyst. Future research should ensure that high-quality genetic interventions are provided to participants, and should consider validate...

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Section: Discussionsupporting

confidence: 93%

A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory?

et al. 2018

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“…21 Though the baseline sample of current smokers in this study was small, these promising results suggest that genomic health information can motivate quitting. However, meta-analyses have shown that although genetic results may increase cessation motivation 11 and behaviors within 6 months, 22,23 these results are not associated with abstinence at longer follow-ups. A next step is to examine how to propagate these positive behavioral changes over the long term.…”

Section: Discussionmentioning

confidence: 99%

Implications of Personal Genomic Testing for Health Behaviors: The Case of Smoking

Olfson

Hartz

Carere

et al. 2016

NICTOB

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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.

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“…lung cancer) [5,6], and identification of genetic variants directly related to nicotine dependence [7]. This article will focus on the latter category: genetic information related to nicotine dependence.…”

Section: Introductionmentioning

confidence: 99%

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

Giordimaina

Sheldon²,

Petty³

2014

Public Health Genomics

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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.

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Impact of Genetic Notification on Smoking Cessation: Systematic Review and Pooled-Analysis

Cited by 21 publications

References 33 publications

A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory?

A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory?

Implications of Personal Genomic Testing for Health Behaviors: The Case of Smoking

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

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