Opinions of lung cancer patients on tobacco advertising and smoking in public places

Background

Non-smokers favour restrictions on cigarette advertising and restrictions on smoking in public places. It might be anticipated that lung cancer patients, faced with the dire consequence of their smoking, might also be relatively hostile to cigarette advertising and smoking. To our knowledge such a difference in opinion has not previously been studied. We surveyed the opinions of lung cancer patients (the cases) and compared them to those of members of the general population (the controls).

Methods

Each of the 46 lung cancer cases had been seen by one of the participating physicians, and the 468 controls were drawn as a random sample from the general population of Luxembourg. For cigarette advertising, subjects were asked if they approved the banning of advertising for each of 7 sites or media: newspapers, magazines, television, radio, sports grounds, near schools, and hoardings. The dependent variable thus ranged from 0 (no ban approved) to 7 (ban approved for all sites and media). For smoking in public places, subjects were asked if they approved of the banning of smoking in each of 10 locations: schools, public services and enterprises, shops, restaurants, cinemas, doctors’ waiting rooms, railway stations, public transport, and meetings. The dependent variable thus ranged from 0 to 10.

Results

Cases were significantly against cigarette advertising for an average of 1.9 more sites out of 7 than the controls (ANOVA, P=0.0015). Non-smokers favoured a ban on advertising for an average of 1.5 more sites than smokers (P=0.0048). For smoking in public places, the cases approved more restrictions than controls (average difference 1.1 locations out of 10, P=0.0326) and non-smokers approved more restrictions than smokers (P=0.0046). There was no significant effect of age, sex or other variables.

Conclusions

The results showed a clear order of subjects’ hostility to cigarette advertising and smoking in public places: lung cancer patients > non-smoking controls > smoking controls. This is remarkable since almost all the cases were current smokers or recent ex-smokers. Thus the diagnosis of lung cancer in a smoker seemed to shift his or her attitude against smoking practices.