Stigma in cancer: Comparing community and health professionals’ acceptability of smoking and alcohol consumption

Abstract

Colorectal and lung cancers are among the most common and deadly worldwide, often carrying significant stigma—especially when linked to preventable behaviors like drinking and smoking. Alcohol increases colorectal cancer risk, while smoking is the primary cause of lung cancer, leading to perceptions of self-infliction that can worsen distress, delay diagnosis, and hinder treatment. This study is the first to compare the acceptability of smoking versus drinking in cancer contexts. Using a factorial design, 132 community members and 126 healthcare professionals evaluated 72 scenarios varying by cancer type, behavior levels, diagnosis stage, post-diagnosis behavior, and activity level. Overall, drinking was viewed as more acceptable than smoking, especially among those physically active or who quit post-diagnosis. Healthcare professionals were slightly more accepting than the general public. Notably, stigma around smoking lessened at advanced cancer stages. Findings suggest the need for stigma-reducing interventions and more compassionate, nonjudgmental care in oncology settings.