Monday, January 09, 2006

IN MY VIEW: Why the Lung Cancer Alliance's Strategy is So Disturbing

There was a great deal of discussion regarding my commentary in which I criticized the Lung Cancer Alliance for criticizing the California Governor for mentioning smoking and the need to prevent it in his proclamation regarding Lung Cancer Awareness month.

I am appreciative for the insight provided by members of the Lung Cancer Alliance. However, the thing I learned from the feedback was that the attempt to dissociate lung cancer from smoking is far more pronounced and far more deliberate, than I had initially imagined.

And here is why I think this approach is so disturbing.

Basically, the Lung Cancer Alliance is trying to convince policy makers to fund lung cancer research (primarily for treatment) by emphasizing that lung cancer is a disease that affects nonsmokers, not just smokers.

So the basic premise is that the reason for increased lung cancer funding is that the disease affects nonsmokers, and in particular, more nonsmokers than people think.

The Rest of the Story

This campaign is disturbing to me because I think it is highly disrespectful of the value of smokers. By arguing that lung cancer should be funded more heavily because it affects nonsmokers as well as smokers is basically arguing that the lives of nonsmokers are to be more highly valued than those of smokers.

In other words, if all lung cancer were to suddenly become caused only by smoking, then the logical upshot of the Lung Cancer Alliance's argument is that there would be less reason to fund lung cancer treatment.

Frankly, I think this is degrading to smokers. It suggests that somehow, the fact that they smoked makes them less deserving of public resources into the treatment for their disease. Somehow, nonsmokers are more deserving of resources, so if we can convince policy makers that nonsmokers are largely affected by the disease, then the argument for resources will be stronger.

I think the reason to fund lung cancer treatment is that the victims of lung cancer are people. Not that they are nonsmokers. Or that they are former smokers.

Even if the only people who developed lung cancer were those who smoked and continued to smoke, I don't think we should devote any less resources to treating and trying to cure this disease.

But according to the logic of the Lung Cancer Alliance, if lung cancer didn't affect ex-smokers and nonsmokers, there would apparently be a weaker argument for funding treatment.

Now I understand that it is society, and not the Lung Cancer Alliance, that is responsible for the stigma attached to smoking. But the fact of the matter is that the Lung Cancer Alliance's' strategy is not challenging this stigma; it is actually greatly reinforcing it. And by doing so, I think it degrades smokers and makes it less possible, not more possible, to break down the stigma that is holding back precious lung cancer research dollars.

If the problem is that there is a stigma attached to smoking, then the solution seems to me to be to break down the stigma, to attack it, to affirm the value of smokers in society and challenge the notion that they are somehow less deserving of treatment and a cure for their ills.
But the Alliance's strategy is not challenging this stigma, it is actually affirming the stigma, reinforcing it, strengthening it, emphasizing it to policy makers, and trying to institutionalize the stigma as a factor in the decision to fund or not fund medical research.

I think it's time to challenge this stigma and break down the barriers that smokers face, not to help support the stigma and strengthen it.

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