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Smokers are less likely than non-smokers to seek help for a lung cancer ‘alarm’ symptom
  1. C Friedemann Smith1,
  2. K L Whitaker2,
  3. K Winstanley1,
  4. J Wardle1
  1. 1Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
  2. 2School of Health Sciences, University of Surrey, Guildford, Surrey, UK
  1. Correspondence to Dr Katriina Whitaker, School of Health Sciences, University of Surrey, Guildford GU2 7XH, UK; k.whitaker{at}


Background The majority (>85%) of lung cancer cases are linked with smoking, and prognosis is poor because it is often diagnosed at a late stage. One contributor to late-stage diagnosis could be patient delay in help-seeking. We investigated the help-seeking behaviour of smokers and non-smokers for a recent lung cancer alarm symptom.

Methods A health survey was sent to 4913 men and women aged >50 years through through General Practice. It included questions on symptoms experienced in the past 3 months (from a checklist), help-seeking (Yes/No) for each symptom and demographic characteristics including smoking status. Univariable and multivariable binary logistic regression analyses were used to assess the association between smoking status and help-seeking for a cough or hoarseness.

Results Among 2042 participants (42% response rate), 280 (14%) reported ‘cough or hoarseness’ in the past 3 months; of whom 22% were current smokers. Being a smoker was associated with reduced likelihood of help-seeking (OR 0.44; 95% CI 0.23 to 0.83), even after adjusting for demographic factors (OR 0.46; 95% CI 0.21 to 1.00).

Conclusions Delay in help-seeking in smokers for a symptom that is potentially indicative of lung cancer is a cause for concern. Future research could usefully address the psychological mechanisms through which help-seeking in smokers is hindered.

  • Lung Cancer
  • Psychology
  • Tobacco and the lung

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