Intended for healthcare professionals

Rapid response to:

Primary Care

Stigma, shame, and blame experienced by patients with lung cancer: qualitative study

BMJ 2004; 328 doi: (Published 17 June 2004) Cite this as: BMJ 2004;328:1470

Rapid Response:

Stigmatisation benefits even smokers who develop a Cancer

Stigmatisation is of overall benefit to the society and is an
essential tool to counteract the ‘peer pressure’, which is a prime factor
in inducing youngsters to take up smoking.

On an individual level, Stigmatisation benefits even the smokers who
develop a cancer (1). Compared with Never-smokers and Ex-smokers, Current
Smokers i.e. patients who smoke while receiving treatment for their
cancers have poorer survival rates (2 3). They also experience more
treatment related toxicity (4). Moreover, even after the successful
treatment of a smoking related cancer, patients who continue to smoke are
at risk of developing a second primary cancer (5). Hence, smoking
cessation even at diagnosis would benefit the smokers.

There is no greater incentive to stop smoking than the diagnosis of a
smoking related cancer. Hence, the associated stigma has a greater
potential to benefit rather than harm cancer patients.


1. Chapple A, Ziebland S, McPherson A. Stigma, shame, and blame
experienced by patients with lung cancer: qualitative study. BMJ

2. Videtic GM, Stitt LW, Dar AR, Kocha WI, Tomiak AT, Truong PT, et
al. Continued cigarette smoking by patients receiving concurrent
chemoradiotherapy for limited-stage small-cell lung cancer is associated
with decreased survival. J Clin Oncol 2003;21(8):1544-9.

3. Browman GP, Wong G, Hodson I, Sathya J, Russell R, McAlpine L, et
al. Influence of cigarette smoking on the efficacy of radiation therapy in
head and neck cancer. N Engl J Med 1993;328(3):159-63.

4. van der Voet JC, Keus RB, Hart AA, Hilgers FJ, Bartelink H. The
impact of treatment time and smoking on local control and complications in
T1 glottic cancer. Int J Radiat Oncol Biol Phys 1998;42(2):247-55.

5. Richardson GE, Tucker MA, Venzon DJ, Linnoila RI, Phelps R, Phares
JC, et al. Smoking cessation after successful treatment of small-cell lung
cancer is associated with fewer smoking-related second primary cancers.
Ann Intern Med 1993;119(5):383-90.

Competing interests:
None declared

Competing interests: No competing interests

19 June 2004
Santhanam Sundar
Consultant Oncologist
Nottingham City Hospital