Stigma Around Smoking Deepens Depression

Lung cancer patient depression exacerbated by social stigma

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Living with a life threatening disease such as cancer isn't always a joyful experience. Depression can follow because of the sadness of the situation. The depression felt by some cancer patients is triggered not just by sadness.

Smoking is no longer socially embraced. Smokers often feel isolated and stigmatized. When this addiction leads to lung cancer, feelings of shame can lead to higher levels of depression than other cancer patients experience.

"Ask for help if you're feeling depressed after your diagnosis."

Researchers at Moffitt Cancer Center in Tampa, Florida have found that social stigma, rejection and isolation, along with internalized shame contribute to the depression lung cancer patients often feel.

"Given its strong association with tobacco use, lung cancer is commonly viewed as a preventable disease," said study co-author Paul B. Jacobsen, Ph.D., Moffitt's associate center director for Population Sciences.

"Consequently, patients may blame themselves for developing lung cancer and feel stigmatized," Jacobsen said. And this shame/blame extends even to people who have never smoked.

The study was designed to identify the causes of depression in lung cancer patients so that interventions could be developed. Stigma was one of the factors included in the analysis.

Study participants were made up of people with stage II, III or IV non-small cell lung cancer. Researchers gathered information on their depressive symptoms with a questionnaire.

From the survey, researchers learned that 38 percent of the patients were depressed, according to study co-author Brian D. Gonzalez, M.A., of Moffitt's Department of Health Outcomes and Behavior.

He said that "greater levels of perceived stigma were related to greater levels of depression." These patients tended to have less social support and what he termed "avoidant coping" and "more dysfunctional attitudes." 

"Depression is a very common symptoms among patients with cancer," Shelli R. Kesler, Ph.D. told dailyRx.

"This study highlights the importance of assessing the specific factors underlying depressive symptoms in specific cancer populations, as these may vary across patients as well as groups of patients," said Kesler, who is assistant professor of psychiatry at Stanford University and director of the Neuropsychology and Neurorehab Lab there.

In terms of treatment interventions, Gonzalez said that therapy focusing on "altering the patient's thoughts and feelings associated with their perceptions of stigma may prove effective in reducing depressive symptoms. For example, emphasizing the addictiveness of tobacco products and the deception in tobacco industry advertising could help patients view themselves as being 'wronged' rather than as a 'wrong-doers,'" Gonzalez concluded.

This study was published in March 21, 2012 issue of Psycho-Oncology.

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Review Date: 
March 27, 2012
Last Updated:
March 28, 2012