Smoking is associated with pessimistic and avoidant beliefs about cancer: results from the International Cancer Benchmarking Partnership

Br J Cancer. 2015 May 26;112(11):1799-804. doi: 10.1038/bjc.2015.148. Epub 2015 May 7.


Background: Smoking cessation is the key cancer prevention behaviour for smokers; nonetheless, smokers can still benefit from earlier diagnosis of cancer. However, fewer smokers participate in screening despite their increased risk, which may reflect different beliefs about cancer.

Methods: A UK population-representative sample of ⩾50 year-olds (n=6965) was surveyed using the Awareness and Beliefs about Cancer measure. These analyses examine six items on cancer beliefs (e.g., 'cancer can often be cured'), and four on help-seeking barriers (e.g., 'I would be too embarrassed').

Results: Smokers were more likely to hold pessimistic cancer beliefs than never-smokers or former-smokers on four of six items. For example, 34% agreed 'a cancer diagnosis is a death sentence', compared with 24% of non/former-smokers (P<0.001). More smokers (18%) than non/former-smokers (11%) would not want to know if they had cancer (P<0.01). The only barrier to symptomatic help-seeking differing by smoking status was 'worry about what the doctor might find' (36% vs 28%, P<0.01). Associations were independent of demographics, self-rated health and cancer experience.

Conclusions: Smokers held more pessimistic and avoidant beliefs about cancer, which could deter early-detection behaviour. A better understanding of these beliefs is needed to increase engagement in early diagnosis by this high-risk group.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Attitude to Health*
  • Early Detection of Cancer*
  • Female
  • Humans
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / psychology*
  • Male
  • Middle Aged
  • Risk
  • Smoking / adverse effects*
  • Smoking / psychology