Potential for genetics to promote public health: genetics research on smoking suggests caution about expectations.

The number of DNA-based tests available for use in clinical care has rapidly increased over the past decade, and this trend has implications for public health and preventive medicine. In the 1990s, Coughlin1 described an "emerging paradigm of disease prevention—the identification and modification of environmental risk factors among persons susceptible to disease due to genotype." This optimistic vision of genetically based prevention was applied to lung cancer when Collins introduced "John," who joins a support group of persons at genetically high risk of complications of smoking and thereby kicks the habit.2 Yet a closer look raises questions about public health and research priorities.3 Clearly, smoking-induced lung cancer, first described by Rottman4 in 1898, continues to be a major public health concern. Lung cancer is the leading cause of cancer-related death in the United States.5 Smoking cessation reduces the chance of . . . [Full Text of this Article]

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