Reducing stigma triggered by assessing smoking status among patients diagnosed with lung cancer: De-stigmatizing do and don't lessons learned from qualitative interviews Journal Article


Authors: Ostroff, J. S.; Banerjee, S. C.; Lynch, K.; Shen, M. J.; Williamson, T. J.; Haque, N.; Riley, K.; Hamann, H. A.; Rigney, M.; Park, B.
Article Title: Reducing stigma triggered by assessing smoking status among patients diagnosed with lung cancer: De-stigmatizing do and don't lessons learned from qualitative interviews
Abstract: Objective: To characterize lung cancer patients' reactions to cancer care providers' (CCPs) assessment of smoking behavior and to develop recommendations to reduce stigma and improve patient-clinician communication about smoking in the context of lung cancer care. Methods: Semi-structured interviews with 56 lung cancer patients (Study 1) and focus groups with 11 lung cancer patients (Study 2) were conducted and analyzed using thematic content analysis. Results: Three broad themes were identified: cursory questions about smoking history and current behavior; stigma triggered by assessment of smoking behavior; and recommended dos and don'ts for CCPs treating patients with lung cancer. CCP communication that contributed to patients' comfort included responding in an empathic manner and using supportive verbal and non-verbal communication skills. Blaming statements, doubting patients' self-reported smoking status, insinuating subpar care, nihilistic statements, and avoidant behaviors contributed to patients' discomfort. Conclusions: Patients often experienced stigma in response to smoking-related discussions with their CCPs and identified several communication strategies that CCPs can use to improve patients' comfort within these clinical encounters. Innovation: These patient perspectives advance the field by providing specific communication recommendations that CCPs can adopt to mitigate stigma and enhance lung cancer patients' comfort, particularly when taking a routine smoking history. © 2022 The Authors
Keywords: aged; major clinical study; cigarette smoking; cancer diagnosis; lung cancer; smoking; risk factor; self report; interview; tobacco dependence; verbal communication; environmental exposure; stigma; semi structured interview; avoidance behavior; content analysis; nonverbal communication; empathic communication; human; male; female; article; patient-provider communication; lung cancer stigma; people by smoking status
Journal Title: PEC Innovation
Volume: 1
ISSN: 2772-6282
Publisher: Elsevier BV  
Date Published: 2022-12-01
Start Page: 100025
Language: English
DOI: 10.1016/j.pecinn.2022.100025
PROVIDER: scopus
PMCID: PMC9977138
PUBMED: 36865902
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Jamie S. Ostroff -- Source: Scopus
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MSK Authors
  1. Jamie S Ostroff
    342 Ostroff
  2. Smita Banerjee
    123 Banerjee
  3. Bernard J Park
    263 Park
  4. Kathleen A Lynch
    71 Lynch
  5. Noshin M Haque
    12 Haque