Tuesday, January 03, 2006

Lung Cancer Alliance Blasts California Governor for Linking Lung Cancer with Smoking

Yes - you read the headline of this post correctly. But I'll repeat it just to make sure that you got it:


The Lung Cancer Alliance, "the only national non-profit organization dedicated solely to advocating for people living with lung cancer or at risk for the disease," has criticized the California Governor's office for stressing the link between smoking and lung cancer and emphasizing the need to prevent smoking in order to address the lung cancer problem.

According to an article in yesterday's Modesto Bee:

"In recent months, Gov. Schwarzenegger's office has endured an earful, with protesters complaining that his proclamation recognizing 'Lung Cancer Awareness Month' largely ignored the trends [towards increasing lung cancers among nonsmokers], instead focusing on the role of tobacco in promoting lung cancer.

'It should be more appropriately called an anti-smoking proclamation,' said Nancy Michener, chairwoman of the California steering committee for the Washington, D.C.-based Lung Cancer Alliance. Michener asked for the proclamation and suggested language for it. Michener's version states that former smokers and people who have never smoked make up the majority of new lung cancer cases, and it decries the lack of screening and funding for lung cancer research. By contrast, the document published by the governor's office emphasizes the role of active smoking in the disease and the state's leadership in efforts to prevent tobacco use."

The Rest of the Story

Let's get this straight. A lung cancer patient advocacy group whose mission is to advocate for the prevention and treatment of lung cancer is critical of emphasizing the role of smoking in the disease and in emphasizing efforts to prevent tobacco use.

Either I'm reading this incorrectly, or this is one of the most absurd stories I've ever reported.

I've heard of the tobacco industry trying to de-emphasize the role of smoking in causing lung cancer, but never a non-profit health-based advocacy group. Why would such a group want to help do the tobacco industry's bidding by undermining public health efforts to achieve public appreciation of the undeniable link between smoking and lung cancer and the importance of efforts to prevent smoking as the most critical aspect of the nation's response to the lung cancer problem?

What is apparently behind the Lung Cancer Alliance's efforts is a desire to remove the stigma from lung cancer so that more dollars will be released for lung cancer research. And to remove the stigma, the Alliance is attempting to emphasize that the majority of lung cancer victims are not smokers - they are ex-smokers or nonsmokers.

While I completely agree with the ultimate goal of the Lung Cancer Alliance (increasing funding for efforts to prevent and treat this devastating disease) and I agree that the stigma associated with the disease (because it is so largely tied to a modifiable behavior - smoking) is related to the underfunding of research in this area, I do not agree with the tactic of trying to de-emphasize the link between smoking and lung cancer.

First, I think the tactic is disingenuous. I don't think it is at all accurate or honest to suggest that smoking is not the primary, predominant cause of the lung cancer epidemic, that it is not inextricably tied to the lung cancer problem in this country, and that efforts to prevent smoking are the most critical aspect of any rational plan to address this problem.

Second, I think the tactic could do a lot of harm. By undermining the public's appreciation of the well-established link between smoking and lung cancer, the campaign would be expected to actually increase smoking rates and make the problem worse, not better. It makes no sense to me to cause more people to get lung cancer in order to obtain more funding to help them once they get the disease.

Third, I disagree with the strategy being used by the Alliance to deal with the stigma associated with lung cancer. If the Alliance wants to deal with the stigma, which I think is essential, then the proper way to do it, I think, is to deal directly with the stigmatization of smokers in our society. To try to pretend that the disease is not so highly related to smoking, or that a modifiable behavior is not the predominant cause, makes little sense to me.

I think we need to be a little more honest, direct, and courageous and confront the problem where it really lies: in the stigmatization of smokers. That's the stigma that needs to be directly challenged, confronted, and eventually, eliminated. But let's do that directly, rather than playing a semantic game and trying to make it seem that smoking somehow isn't the overwhelming and predominant reason why lung cancer exists as a public health problem in the United States.

We need to be emphasizing the addictive nature of nicotine and the efforts by the cigarette companies to manipulate nicotine levels and the addictive strength of their products in order to hook smokers. This is the way to take some of the victim-blaming out of the picture and to make it clear that there is a corporate responsibility here, not just a problem of poor personal choices.

If anything, the Lung Cancer Alliance's strategy is, I think, going to make the stigmatization problem worse because the Alliance is actually highlighting the stigma and reinforcing it. And by doing so, I'm afraid the Alliance is perhaps hurting many of the people (smokers and ex-smokers) who it is supposed to be helping.

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