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Stigma Adds to Pain of Lung Cancer

Scary Antismoking Ads, News Stories Often Hard on Patients
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WebMD Health News

June 10, 2004 -- Lung cancer carries a special stigma that makes patients' life harder.

The finding comes from a remarkable series of 45 highly personal interviews. The one-on-one sessions are part of Britain's DIPEx project, which provides Internet-based support for patients with a variety of illnesses. Several of the interviews can be seen on the DIPEx web site.

Oxford University researcher Alison Chapple, PhD, RN, and colleagues find that lung cancer patients say there's a lot of stigma associated with their disease. This makes their life much harder than it has to be, they report in the early online edition of the British Medical Journal.

The stigma stems from two sources. One is that 90% of lung cancers are linked to smoking. Many people thus feel lung cancer is a self-inflicted disease. This cuts patients off from the support cancer patients might normally receive and shames them.

The other source of stigma is fear. Lung cancer is seen as a particularly horrible disease. Patients report that family and friends often avoid them out of embarrassment and disgust.

"People think you're dirty because you smoked," one respondent told Chapple. "But also I think that they can't bear to think that they're going to see you suffer.

Antismoking Ads Cut 2 Ways

One troubling source of stigma against people with lung cancer results from good intentions. Antismoking ads often try to scare young people away from cigarettes with depictions of clogged, blackened lungs and dire warnings of a drowning-like death.

For someone trying to survive the disease, such ads can be difficult to watch.

"There is a dilemma for antismoking campaigns and for clinicians who take seriously their responsibility to deter people from smoking and to encourage smokers to stop," Chapple and colleagues write. "Those who produce images of 'dirty lungs' rightly aim to put young people off tobacco. But such images may upset people with smoking related illness."

Here's what a 73-year-old lung cancer patients says: "I hate those adverts that come on the television when they finish it by saying two weeks after this she died. And one of them said when you've got lung cancer you drowned. ... I was really offended by this -- well, by all of them. I know they're to stop people smoking but they're not pleasant to watch when you've got lung cancer."

Who's Really to Blame?

Chapple and colleagues note that it's hard to resist pressures to start smoking -- and that it's even harder to stop. It may do more good, they suggest, to stop blaming smoking victims and to put the blame elsewhere.

"Publicity about the Machiavellian role of the global tobacco industry may resonate with young people while avoiding further victim blaming of those with lung cancer and other smoking related diseases," they write.

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