Primary care physicians' concerns about offering a genetic test to tailor smoking cessation treatment.

Abstract

We assessed the importance assigned by primary care physicians to eight factors influencing whether they would order a genetic test to individually tailor smoking cessation treatment. A random sample of United States primary care physicians was surveyed about how important each of eight factors were in the decision to order the test. Broadly, these factors included the ability of the test to improve treatment, the patient's reaction to test results, concern about misuse of test results, and the ability of the physician's office to manage informed consent for the test. Physicians indicated the most important factor they would consider in ordering a genetic test to tailor smoking cessation treatment was the ability to improve cessation outcomes. However, when told the genotype identified by the test was associated with stigma-inducing mental health conditions, physicians emphasized the importance of possible racial, insurance, and employment discrimination in their decisions. Primary care physicians are eager to improve smoking cessation treatment, but the collateral information generated by genetic testing to tailor treatment may be an impediment unless proper antidiscrimination measures are in place.