‘Did you smoke?’ This is the most comment question that people diagnosed with lung cancer are faced with. The stigma attached to lung cancer, and to smoking, has an enormous impact on individuals and the societal response to the disease. Evidence shows that people with lung cancer experience greater levels of stigma, psychological distress, poor physical morbidity and have higher suicide rates compared to people diagnosed with other cancers. The impact of stigma in lung cancer is pervasive across the cancer control spectrum, from the earliest points of prevention to survivorship and palliative care. Current and former smokers report feeling shame, guilt or being discriminated against and experience social isolation. Never-smokers are more likely to conceal their diagnosis from others. Despite being the number one cause of cancer death worldwide, funding for lung cancer research and support services continues to be under-resourced.
In this presentation, I will consider the impacts of stigma as well as the opportunities to create change and empower individuals and communities. The patient population includes ‘hard to reach’ groups such as current and former smokers, people from socially disadvantaged communities, those living in rural and remote areas and from different cultural backgrounds. Interventions must contain non-judgemental elements to appeal to the ‘hard to reach’. I will draw on examples from the lung cancer screening and survivorship literature to show how public health messaging and implementation research could be leveraged to create positive change and reduce the impact of stigma.