Patient views on smoking, lung cancer, and stigma: a focus group perspective

Purpose: Patients with lung cancer, the leading cause of cancer death, are shown to have high levels of psychological distress and poorer quality of life as compared to patients with other cancer types. The purpose of this paper is to describe patient focus group discussions about the lung cancer experience in relation to perceived stigmatization, smoking behaviors, and illness causes; and to discuss implications of these findings relative to the role of the nurse as a patient advocate.

Methods and sample: Eleven adult lung cancer patients participated in audio taped focus group sessions. Discussion questions probed patient perceptions of lung cancer challenges and adaptation issues.

Results: Six primary themes from the qualitative analysis included: 1) societal attitudes; 2) institutional practices and experiences; 3) negative thoughts and emotions such as guilt, self-blame and self-deprecation, regret, and anger; 4) actual stigmatization experiences; 5) smoking cessation: personal choices versus addiction; and 6) causal attributions.

Conclusions: Patients with lung cancer uniquely experience an added burden from developing an illness that the public recognizes is directly associated with smoking behaviors. Stigmatization and smoking related concerns are of high importance. Oncology nurses must be at the forefront in ensuring that patients with lung cancer do not experience additional burden from perceptions that they somehow deserve and need to defend why they have the illness that they are facing.