Researchers in Oxford interviewed 45 patients with lung cancer for DIPEx (Personal Experiences of Health and Illness) www.dipex.org
Whether they smoked or not, patients with lung cancer felt particularly stigmatised because the disease is so strongly associated with smoking and because some patients die in an unpleasant way.
Interaction with family, friends, and doctors was often affected as a result, and many patients, particularly those who had stopped smoking years ago or had never smoked, felt unjustly blamed for their illness. One said: "people automatically think you've brought it on yourself and it's a sort of stigma."
Some patients concealed their illness, which sometimes had serious consequences, such as deterring patients from seeking all the help they needed. Some criticised the media for adding to the stigma, while others maintained that the real culprits were tobacco companies with unscrupulous policies.
A few patients were worried that treatment and research into lung cancer might be adversely affected by the stigma attached to the disease and those who smoke.
Efforts to help people to quit smoking are important, say the authors, but there is a dilemma for anti-smoking campaigns and for clinicians who take seriously their responsibility to deter people from smoking and to encourage smokers to stop.
Those who produce images of "dirty lungs" rightly aim to put young people off tobacco, but such images can upset people with smoking related illness. In contrast, 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 conclude.