“IT SOUNDS LIKE SOME BS”: ACCEPTANCE AND REJECTION OF GENETIC RISK COMMUNICATION

Purpose: Translating genomics research into clinical and public health practice depends, in part, on the extent to which the public accepts genetics-related risk communication.  We explored how smokers accepted or rejected information describing the discovery of a genetic variant associated with an increased risk of nicotine addiction and lung cancer.

   Methods: The study methodology was based on the constructivist paradigm, which asserts that a person or group’s reality is based on specific social and individual experiences. Eighty-five current cigarette smokers participated in one of thirteen focus groups and one interview.  Groups were stratified by education (seven <Bachelor’s degree, seven ≥Bachelor’s degree) and race (eight black, six white).  Participants were recruited from community locations (e.g., tobacco shops, laundromats, music festivals).  Participants were shown a one-minute video of a true news story that described the discovery of a genetic variant associated with an increased risk of having severe nicotine addiction and an increased risk of developing lung cancer.  Participants were asked to provide their opinions about the information.  Data were analyzed using grounded theory.  Codes were identified inductively to identify concepts that emerged spontaneously from participants, and deductively for a priori concepts of interest.  Two independent coders used an iterative strategy to analyze and interpret the data.

   Results: Pre-existing knowledge (before the video) about why people smoke cigarettes and what the term “genetic risk” means informed beliefs about the relationship between genes and addiction.  These beliefs were not always consistent with biomedical explanations, but they formed the context through which participants seemed to process the information in the video.  This in turn led to message acceptance or rejection.  Participants explained their reactions to the video in terms of the scientific merits of the research.  They also used their pre-video knowledge and beliefs to explain their acceptance or rejection of the message.

   Conclusions: Laypeople hold complex understandings of genetic risk, including genetic risks associated with nicotine addiction and lung cancer.  When lay and biomedical explanations of genetics and genetic risk diverge, however, laypeople may reject genetics-related risk communications.  Future research should identify strategies that bridge this gap.  Until this occurs, laypeople may be less accepting of certain types of genetic risk information.  This could impede the translation of genomics research into clinical and public health practice.