Patients With Lung Cancer Respond to ‘Did You Smoke?’


The members of my lung cancer support group recently came up with some responses for when people ask us, "So you have lung cancer — did you smoke?"

Focus on caucasian young woman hand putting out cigarette on glass ashtray on wooden table, cigarette butt, smoking is dying. Quit smoking. Health concept. Close up photo. | Image credit: ViDi Studio - © -

The Living!!! With Lung Cancer Support Group meets virtually twice per month and is moderated by University of Kansas Cancer Center social worker Sarah Bechard. We are dedicated to building survivorship skills for fellow lung cancer patients and their caregivers.

Recently, several of our members attended a lung cancer awareness event hosted by the Lung Cancer Research Foundation (LCRF). Participants included representatives from a variety of national lung cancer advocacy groups.

Laura said she was surprised at the number of people at the event who asked her: “So you are a lung cancer survivor. Did you smoke?”

The rest of the group responded with a unanimous groan.

How should she have answered that question?

At the time, she tried to joke about it. “Well I lived in Las Vegas…so yeah, everybody smoked!”

We thought that anyone attending such an event should know better. Though most of those questioners were connected to pharmaceutical companies, they left Laura with a heavy feeling of guilt. She felt as though they were blaming her for getting cancer.

We immediately understood her feelings.

Sarah suggested that we come up with some responses so that such questions would not catch us off guard, or worse, set us on a downward emotional spiral. Our discussion took off from there, and we spent the next two weeks collecting possible responses.

Some of our answers were admittedly snarky. For example, Don said he has answered flippantly with “Sure I smoked, grew up in a house with radon, and worked around asbestos. Any more questions?”

Ann has been asked the question by medical fellows or residents, who she feels should be better informed. Her two favorite answers are “Well no, my lung cancer is the contagious kind,” and “Why are you asking me this, did you call in sick on the day that they taught lung cancer?”

For acquaintances who have no personal stake in your health situation, you could turn it back on them. “Why do you ask? Do you smoke?”

A friend gave Barbara a suggestion: “Sure I started smoking when I was 3, but I quit when I was 11.”

A never smoker, Barbara hoped to respond honestly to the interrogator. “I never know how to answer that question. On the one hand, I feel as if I am being blamed for getting cancer. On the other hand, I wonder why so many people who smoke never get cancer.”

The fact is that 10-15% of lung cancer patients are never smokers, according to research from the National Cancer Institute. Never smokers represent the majority of members in our support group. According to a 2022 study conducted by the Albert Einstein College of Medicine, only 10 to 20% of lifelong smokers get lung cancer.

Researchers have discovered a variety of links to lung cancer: environmental toxins such as air pollution, asbestos, and radon; hormonal changes for menopausal women; alcohol and tobacco use, and DNA mutations are among them.

The American Cancer Society suggests we think about how to answer curious questions from people we don’t know. You could say “I’d prefer not to go into details” or “Thank you so much for your concern, but I need to focus on something else today.”

One could also just say nothing.

“I was a smoker, and I loved every minute of it,” said Kristine. “When they asked me if I smoked, I felt shame, I got really upset about it... I bring up Christopher Reeve and his wife who died from lung cancer, but they didn’t smoke.”

Ann said she wishes she knew what caused her cancer. For those who are just curious, she answers “No, I didn’t smoke… my DNA got rearranged and they really don’t know how that happened.”

Don feels as though his stressful life led to a cancer diagnosis. At the time, he said, “I was living in Tulsa and building a house in another city. I was eating terribly, not working out, and super, super stressed. I was never a smoker. I wasn’t drinking, or doing anything really bad. It was just me not taking care of myself. “

Chris shared that if you don’t feel like being nice, you could hand them a sizzle card printed with the letters “WTF?” “Why are your eyes the color they are?” she said, “Why do you have freckles or a cold?”

To Judy, the question about the cause for her cancer is unanswerable. “You can look at a thousand different things, but there is no answer. I can’t find the answer, we don’t know the answer, and so you go on.”

Perhaps the most appropriate answer is a phrase we repeat frequently in our group like a mantra:

Anyone with lungs can get lung cancer.

This post was written and submitted by Barbara Sheehan. The article reflects the views of Barbara Sheehan and not of CURE®. This is also not supposed to be intended as medical advice.

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