BACKGROUND Lung cancer patients commonly report stigma, often attributing it to the well-established association of smoking as the leading preventable cause. Theory and research suggest that patients' smoking history may differentiate patients' experience of lung cancer stigma. However, there is inconsistent evidence whether lung cancer stigma varies by patients' smoking history, owing to limitations in the literature. PURPOSE This study examined differences in lung cancer patients' reported experience of lung cancer stigma by smoking history. METHOD Participants (N = 266, 63.9% female) were men and women with lung cancer who completed a validated, multidimensional questionnaire measuring lung cancer stigma. Multivariable regression models characterized relationships between smoking history (currently, formerly, and never smoked) and lung cancer stigma, controlling for psychological and sociodemographic covariates. RESULTS Participants who currently smoked reported significantly higher total, internalized, and perceived lung cancer stigma compared to those who formerly or never smoked (all p < .05). Participants who formerly smoked reported significantly higher total and internalized stigma compared to those who never smoked (p < .001). Participants reported similar levels of constrained disclosure, regardless of smoking history (p = .630). CONCLUSIONS Total, internalized, and perceived stigma vary meaningfully by lung cancer patients' smoking history. Patients who smoke at diagnosis are at risk for experiencing high levels of stigma and could benefit from psychosocial support. Regardless of smoking history, patients reported similar levels of discomfort in sharing information about their lung cancer diagnosis with others. Future studies should test relationships between health-related stigma and associated health behaviors in other stigmatized groups.

中文翻译：

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肺癌的耻辱：吸烟史重要吗？

背景肺癌患者通常报告有耻辱感，通常将其归因于已确立的吸烟作为主要可预防原因的关联。理论和研究表明，患者的吸烟史可能区分患者对肺癌病耻感的体验。然而，由于文献的局限性，肺癌病名是否因患者的吸烟史而异，并没有一致的证据。目的 本研究调查了肺癌患者因吸烟史而报告的肺癌病耻感经历的差异。方法 参与者（N = 266，63.9% 女性）是患有肺癌的男性和女性，他们完成了一项经过验证的多维问卷，测量肺癌病耻感。多变量回归模型描述了吸烟史（目前、以前、并且从不吸烟）和肺癌耻辱，控制心理和社会人口统计学协变量。结果 与以前吸烟或从不吸烟的参与者相比，目前吸烟的参与者报告的总体、内化和感知到的肺癌病耻感显着更高（所有 p < .05）。与从不吸烟的参与者相比，以前吸烟的参与者报告的总体和内化耻辱感明显更高（p < .001）。无论吸烟史如何，参与者都报告了类似的限制披露水平（p = .630）。结论 肺癌患者的吸烟史对总体、内化和感知的耻辱感有显着差异。在诊断时吸烟的患者有遭受高度污名化的风险，并且可以从社会心理支持中受益。无论吸烟史如何，患者在与他人分享他们的肺癌诊断信息时报告了类似程度的不适。未来的研究应该测试与健康相关的污名与其他受污名群体的相关健康行为之间的关系。