Smoking prevalence fell steeply after the 1960s when smoking was linked to lung cancer through epidemiological studies, which is long before public health measures were adopted. It is generally accepted that although most smokers want to quit, their smoking habit is maintained by the combination of addiction and optimistic bias (denial). Smokers demonstrate varying degrees of optimistic bias, the belief that complications of smoking will affect other smokers but not them. A new paradigm in smoking cessation called the 3Ts encompasses Tension, Trigger and Treatment. Motivational tension is the state of anxiety a smoker feels about their smoking. This tension can be elevated by triggers (teachable moments) such aswhich might be a health scare highlighting their vulnerability to smoking the complications of smoking and thereby undermining the optimistic bias. There is growing evidence that smokers respond to triggers by quitting, with at greater quit rates being relative to theaccording to the severity of the trigger. Quit rates in smokers are as high as 50–60% after a heart attack or diagnosis of lung cancer. Triggers may also involve the assessment of risk for a future life threatening event. Older smokers cite fear of future poor health as the most important trigger to quitting. Advances in genetic technology hasAdvances in genetic technology have revealed a number aof genetic variants that are associated with lung cancer susceptibility and that in combination (several susceptibility variants and along with clinical variables), identifies identify those smokers who are at greatest risk. There is growing evidence that personalized genomics information is accepted by lay people, promotes positive treatment changes by doctors and helps smokers to quit. There is also data to suggest that smokers taking these susceptibility tests are not de‐motivated from quitting by taking the results of these tests. The paper will present data to support these claims suggesting personalized genomics could assist existing public health measures to promote smoking cessation. Such a personalized approach has been successfully used in the risk factor modification of coronary risk factors and significant reduction in coronary mortality over the last 2 decades.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B145.