Experience of, awareness of and help-seeking for potential cancer symptoms in smokers and non-smokers: A cross-sectional study

PLoS One. 2017 Aug 28;12(8):e0183647. doi: 10.1371/journal.pone.0183647. eCollection 2017.


Background: Presenting to primary care with potential cancer symptoms is contingent on one's ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms.

Methods: Smokers and non-smokers aged over 50 from Yorkshire general practice lists were sent a postal questionnaire asking about symptoms, consulting and awareness of cancer symptoms. Data were analysed using STATA14.

Results: Response rate after one reminder was 30.5% (1205/3954). Smoking status was associated with experience of cough (p<0.001), breathlessness (p = 0.002) and tiredness (p = 0.004) with smokers (25.8% of population) more likely than never-smokers (53.6% of population) to experience all three symptoms (cough OR = 2.56;95%CI[1.75-3.75], breathlessness OR = 2.39;95%CI[1.43-4.00], tiredness OR = 1.57;95%CI[1.12-2.19]). Smoking status was associated with awareness of breathlessness as a potential cancer symptom (p = 0.035) and consulting for cough (p = 0.011) with smokers less likely to consult than never-smokers (OR = 0.37;95% CI[0.17-0.80]).

Conclusion: Our findings suggest that current smokers are more likely to experience cough, breathlessness and tiredness, but are less likely to consult for cough than never-smokers. To increase cancer awareness and promote consulting among smokers, innovative interventions improving symptom recognition and empowering smokers to seek help are required.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Awareness*
  • Cough
  • Cross-Sectional Studies
  • Dyspnea
  • Fatigue
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / physiopathology*
  • Pain
  • Patient Acceptance of Health Care*
  • Smoking / psychology*
  • Smoking Cessation / psychology*
  • Surveys and Questionnaires