Lay Understanding of Race, Addiction and Genetics

Research is currently underway that seeks to deepen our understanding of the role of genetic factors in substance dependence and response to treatment. In order for the potential benefits of emerging research to be realized, it is crucial to begin understanding how members of different racial/ethnic groups comprehend, interpret and respond to information about the role of genetics in addiction and treatment response, and in particular to reported racial differences in the frequency of alleles hypothesized to increase susceptibility to addiction or affect response to treatment. We use data on the genetics of nicotine addiction and response to treatment to explore these issues. Specific aims are: (1) To explore racial differences (self-identified Black versus white) in beliefs and understandings regarding the role of genetics in addiction; (2) To explore racial differences (self-identified Black vs. white) in attitudes toward the use of genetic testing to improve treatment for addiction; (3) To assess the extent to which individuals' attitudes toward the use of genetic testing in this context change when they are informed of key characteristics of the genotypes that would most likely be used to tailor individual treatment for addiction (e.g., racial differences in the frequency of risk alleles, pleiotropic associations), as reported in the most current scientific literature; (4) Among a subset of self-identified Black and white smokers in the U.S., to assess individuals' intention/willingness to undergo genetic testing in order to be matched to optimal smoking treatment. This study includes extensive qualitative research and a randomized national telephone interview survey of 1200 self-identified Black and 1200 white adults. Focus groups, personal interviews, cognitive interviews, expert review, two rounds of pre-testing, and a pilot survey (N=100) will be used to develop an effective and appropriate survey instrument. The proposed research will be the first to examine how diverse lay audiences understand, interpret and respond to emerging genetic research on addiction and potential clinical applications. Such information is essential to constructively engage the broader public in ongoing and future debates about the integration of emerging pharmacogenetic interventions into clinical practice, and to developing culturally appropriate informed consent processes, interventions and educational activities.