What Not to Ask Someone With Lung Cancer

I know. You can't help it. You learn someone has lung cancer, and your first question is some variation of this: Did/does that person smoke? It seems an innocent enough question. I mean, after all, it says right there on the cigarette pack that smoking causes cancer. Duh! And we learn through anti-smoking campaigns early on that to prevent lung cancer, we ought not smoke.

But unpack that question a little more; when we ask  about whether or not the person with lung cancer smoked, aren't we are also asking for some assurance that if we don't smoke, we won't get lung cancer? In that framework, from the perspective of a self-righteous non-smoker, the implication here is that if a person who has lung cancer did smoke, the disease is that person's own damn fault. The given equation of smoking = lung cancer is ingrained in our culture. So, the question about a person's smoking habits invokes a stigma surrounding lung cancer that not only has social consequences; it affects even the way research funding is directed. See: Is There a Stigma in Lung Cancer Funding Research?

Here's something else to consider. If someone told you they had diabetes, would you ask them if they ate sugar? If someone told you they had heart disease, would you ask them if they ate red meat? If someone told you they had liver cancer, would you ask them about their drinking habits? Probably not. Certainly smoking is one of the chief behaviors correlated with a high risk of cancer, but it is not the only cause. Radon, second-hand smoke, toxic agents, gene mutations all can cause lung cancer. Some lung cancers are just idiopathic, perhaps caused by a perfect storm of any of the above. Some people smoke their entire, lucky lives and never get lung cancer. And I hate to undermine the self-assured non-smoker, but if you have lungs, you can get lung cancer.

So, if you learn someone has a lung cancer diagnosis, don't ask if they smoke. A better question might be: How are you doing?