Returning genetic information about risk for alcohol use disorder to adolescents: Findings of a preliminary qualitative study of precision prevention

•New models of preventing alcohol and other substance use are needed for adolescents•Precision prevention involves returning genetic information to inform health actions•Attitudes favor precision prevention of alcohol use disorder (AUD) risk for teens•Precision prevention is complex, and merits research and testing to optimize benefit•Avoiding harms from distress and unintended cognitive behavioral effects is vital Alcohol use disorders (AUD) are heritable with genetic factors predicting approximately 50% of the risk. Returning information about genetic risk could promote avoidance of alcohol, reducing AUD risk. Explore attitudes toward a precision prevention model of AUD targeting adolescents. Qualitative interviews with adolescents and adults to explore attitudes about precision prevention of AUD. Interviews were recorded, transcribed, and thematically analyzed to identify perceptions about acceptability, salience, potential harms, and benefits. Among N=13 participants (mean age 28.6 years, 7 female), 5 had undergone genetic testing, and 6 had a personal or family history of substance use disorder. Attitudes were favorable toward precision prevention of AUD for adolescents. Perceived benefits included potential to engage youth, motivate behavior change, protect family via sharing genetic information, and prompt insight into family problems. Perceived harms included potential for anxiety, false sense of immunity from AUD should genetic testing indicate no heightened risk, experience of stigma from disclosure or breach of privacy. This qualitative study identified potential harms and benefits of a precision prevention approach for addressing AUD risk targeting adolescents, along with appreciation for the complexities of the model. Research is needed to elucidate operational, ethical, and communication strategies to advance the model. [Display omitted]