Abstract
Personalized risk assessment has been successfully used in coronary heart disease prevention to motivate lifestyle change and target drug therapy. In the Tension, Trigger and Treatment (3Ts) paradigm of smoking cessation, smokers quit smoking when the perceived harms outweigh benefits (or when motivational tension outweighs optimistic bias). Using a gene-based test for lung cancer risk, recently validated in a prospective study, we examined the effect of risk assessment on smoker's attitudes and actions to quitting. In this pilot study, 28 smokers were randomly recruited from a hospital database (eligibility: ≥40 years old, current smoker, and 20+ pack year smoking history). Through a telephone questionnaire, baseline smoking history and recent quit attempts were documented. Smokers were also offered a gene-based risk test for lung cancer risk. 25 (90%) accepted and were followed. On visit 1, smokers were counseled, consented and a cheek swab was taken for genotyping. On visit 2, the lung cancer risk test result was given along with materials on smoking cessation services and medications.
Based on a telephone questionnaire at 6 months after genetic testing (n=25) we found the following; 32% had quit smoking while 48% had reduced their smoking consumption (overall 80% had taken positive steps toward reducing smoking), 48% had used a smoking cessation service or product and only 4% of smokers appeared less committed to quitting. Quit rates were comparable in moderate- and high-risk groups.
We conclude from this pilot study that personalized risk assessment using a gene-based test of lung cancer susceptibility appears to confer a positive effect on quitting smoking. The quit rates achieved in this study occurred in randomly selected smokers and compares favorably with other approaches. We suggest that the risk test provides a teachable moment and enhances motivational tension towards quitting.
Citation Information: Cancer Prev Res 2010;3(12 Suppl):A65.