Stigma - that is, shame, blame and guilt - is sometimes associated with the diagnosis of smoking-related cancers such as lung cancer or head and neck cancers. While only a minority of such groups report high levels of shame, blame and guilt connected to smoking, there is evidence that felt stigma influences interactions with health care providers and the health system. Patients are sometimes reluctant to report current or recent smoking. On receiving a diagnosis of cancer patients may be open to the idea of stopping smoking. Alternatively, they may be fatalistic (it's too late), may feel unable to quit or may remain resistant to stopping smoking. Health professionals also report concerns about how smoking-related discussions might affect relationships with their patients.
This presentation will explore data around these issues and how they frame clinical conversations about smoking. Principles for talking about smoking in oncology settings will be discussed, The presentation will explore how these principles might apply in various contexts, under tight time constraints and to various clinical roles. Varying approaches to conversations such as opt-in versus opt-out will be presented. Examples will be provided of brief versus extended approaches to each of: raising the topic of smoking, providing advice, reaching agreement about action and linking in to evidence-based support.