Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities

The potential benefits of genetically-tailored treatment will remain unrealized if the impact and meaning of reported racial differences in the prevalence of alleles associated with risk of addiction or differential response to treatment is not fully understood.  It is therefore crucial to begin to understand how members of different racial groups comprehend, interpret, and respond to information about the role of genetics in addiction and treatment response.  This project seeks to deal responsibly with an issue that is laced with social tensions and potential discrimination by laying a valuable foundation for future Ethical, Legal, and Social Issues (ELSI) studies aimed at understanding and addressing the ways in which reported racial differences in the prevalence of genotypes associated with increased risk of addiction and other complex genetics issues are likely to affect consumers’ willingness to undergo genetic testing to receive tailored treatment.  Many significant challenges will need to be addressed in order to facilitate the successful integration of novel therapeutic approaches (such as genetically-tailored treatment), including preparing primary care physicians to incorporate pharmacogenetics into clinical practice, patients’ willingness to undergo genetic testing, the resources and infrastructure to deliver such services, adequate financing and reimbursement of pharmacogenetic testing, and privacy and antidiscrimination protections sufficient to reassure physicians and patients that genetic testing will not lead to stigmatization and discrimination.

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Given racial differences in the frequency of alleles believed to confer an increased susceptibility to addiction, successful administration of smoking cessation treatments is partly contingent on successful targeting of patients’ risk of addiction.  In 2009, we conducted a random digit dial survey to compare attitudes and beliefs of 2400 self-identified black and white Americans regarding their attitudes and beliefs of regarding the role of genetics in substance use and dependence, interpretations of reported racial differences in the frequency of alleles associated with increased susceptibility to drug dependence, and smokers’ willingness to undergo testing to be matched to optimal treatment.  This project seeks to gather critical information regarding the clinical utility of genetically tailored treatment for smoking, which may lead to new treatment strategies for smoking within the next 5-7 years. 

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Engaged Faculty

Investigators

• Alexandra E. Shields, Ph.D. (Principal Investigator)

• Eric G. Campbell, Ph.D.

• Elyse R. Park, Ph.D.

• Dianne M. Finkelstein, Ph.D.

• Sowmya Rao, Ph.D.

• Susan Kleimann, Ph.D.

• Anthony Roman, M.A.

• Brian Clarridge, Ph.D.

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Consultants

• Caryn Lerman, Ph.D.

• Rayna Rap, Ph.D.

• Chanita Hughes Halbert, Ph.D.

• Ann Doucette, Ph.D.

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Related Publications

• Park E.R., Kleimann S., Youatt E.J., Lockhart A., Campbell E.G., Levy D., Halbert C.H., Schmieder E., Krishna R., Shields A.E. Black And White Adults’ Perspectives on the Genetics of Nicotine Addiction Susceptibility. Addictive Behaviors. 2011; July; 36(7):769-72. PMID: 21406316.