CT-003 - PERSPECTIVES ON PHARMACOGENETIC-GUIDED TOBACCO CESSATION IN AN AMERICAN INDIAN POPULATION

S. Killam¹, M. Davies², D. Wall², K. Brown², K. Aagaard³, K. Claw³, E. Woodahl²; ¹University of Montana, Missoula, MT, USA, ²University of Montana, ³University of Colorado Anschutz Medical Campus.

Background: Pharmacogenetics (PGx) provides a personalized approach to dose and drug selection to reduce adverse events and improve health care outcomes in many therapeutic areas, including tobacco cessation. Nicotine is primarily metabolized by the enzyme CYP2A6, and variation in the CYP2A6 gene leads to variable nicotine exposure and can, in turn, guide treatment strategies for cessation. We have partnered with the Confederated Salish and Kootenai Tribes (CSKT) on the Flathead Reservation in Montana on a PGx-guided tobacco cessation research project to ensure equitable PGx access for American Indian and Alaskan Native (AIAN) patients.

Methods: We recruited CSKT Tribal members and descendants (n=109) to learn perspectives of the community on using PGx to guide tobacco cessation and to inform future research. We developed a mixed-methods survey to gather participant demographics, current and former tobacco use, tobacco cessation efforts, PGx knowledge, and perspectives on PGx research. We recruited through snowball sampling, co-recruitment efforts, and dissemination of surveys online and in-person at various events across the Flathead Reservation.

Results: The majority of respondents were female (86%) and between ages 18-39 (49%). With regard to tobacco use, 29% reported current commercial tobacco use and 43% reported tobacco use for ceremonial, cultural, or traditional reasons. Encouragingly, 36% felt knowledgeable on precision medicine and PGx and 66% felt PGx would be a useful tool to guide tobacco cessation. In open-ended questions, participants expressed frustration with the prevalent commercial tobacco use in their communities, however, they noted significant concerns regarding PGx research including distrust towards researchers due to the historical injustices and unethical research practices experienced by AIAN people.

Conclusion: Advances in PGx-guided tobacco cessation are promising, however, it is imperative to consider the unique experiences of underserved and Tribal participants. The results of our survey provide insight into the perspectives of the CSKT community on tobacco use, PGx research, and PGx-guided tobacco cessation. We aim to reduce health disparities in disenfranchised communities by expanding access to PGx research and implementation.