Clinging Delusionally

"And that's true [smoking will exacerbate any cancer situation and prognosis] whether or not it's a smoking-related cancer in the first place, or even if it's not a cancer with a strong relationship to smoking."
"We're not laying blame on anybody. I think most of us who are non-smokers, we have our own view of the world. We think, 'oh sure, if I was given a diagnosis of cancer, I'd quit on the spot."
"This is an addiction, and it's very, very difficult to quit."
"If we say 'culpable if you smoke and you're personally responsible for all of the consequences', where does it end? What about eating too much? What about not exercising enough?"
"We're in the business of trying to help people -- not blame them."
Dr. David Mowat, senior scientific lead, population health, Canadian Partnership Against Cancer

"Where do you draw the line? An addiction is a treatable illness. If you've got an illness,  you're going to make judgments about them? It doesn't make a lot of sense -- you need to offer  help with the addiction."
Dr. Kerry Bowman, bioethicist, University of Toronto

Jeff T. Green / Getty Images

Lifestyle has consequences. Sometimes those consequences are a long time surfacing, but eventually they may. And if one's lifestyle is inclusive of an ingrained habit that becomes a fierce need to repeatedly ingest a chemical that is a known carcinogen no one can be surprised, least of all the individual addicted to tobacco, that lung cancer ultimately has the final say. No one in today's world can be ignorant of the simple fact that nicotine is a tried-and-true path to an early death.

People are very adept at blinkering themselves to realities, reasoning that what may happen to others will not necessarily happen to them. After all, it's also a well-known fact that some congenital smokers often don't contract cancer. And that people who have never smoked in their lives are also diagnosed with lung cancer. So for some it's a gamble, and for others it's a situation where they believe they are exempt from the biological breakdowns that afflict others.

It's even highly likely that just about everyone has had the experience of losing someone in their family to the ultimate effects of nicotine, through lung cancer or serious heart problems leading to death. For most people the seriously worrisome knowledge that smoking all too often causes lung cancer is persuasive enough for them to discipline themselves through whatever means are successful, to move toward smoking cessation.

New research, however underscores that of cancer sufferers a significant percentage continue to smoke even after diagnosis. In my own family that includes a father whose surgery and suffering from throat cancer didn't suffice to compel him to stop smoking. And a sister-in-law who, despite open-heart surgery, continued smoking. But not for too long.

In a national health survey which asked "Do you have cancer", one in five Canadians reported smoking daily, roughly analogous to numbers in the non-cancer population. The conclusion by experts was that people consumed by nicotine addiction fail to appreciate the hazards of ongoing smoking, despite those hazards being common knowledge.

Additionally, some people simply shrug off criticism in their belief that since the damage has already occurred, why cease smoking? The reasons for stopping are obvious to the medical science community: smoking blunts chemotherapy and radiation effects resulting in lower survival rates. Smoking increases treatment side effects as well as furnishing the basis of a second cancer appearing.

In some parts of the world people who smoke and develop lung cancer lose their eligibility for state-funded cancer drugs (Turkey). In some areas of England and Wales smokers are not offered access to routine surgery like hip and knee replacements until such time as they cease smoking. Dr. Mowat and others in the field in Canada don't subscribe to that line of reasoning.

Their study was published in the journal Current Oncology, based on four years of data -- 2011 to 2014 -- extracted from the Canadian Community Health Survey. Twenty-two and a half million people without cancer were compared to 338,450 cancer patients and of the two percent "current  cancer patients", 20.1 percent reported smoking, as compared to 19.3 percent in the non-cancer population.

"A considerable proportion of smokers did not quit when faced with a cancer diagnosis in Canada", the researchers concluded. The research findings did not, on the other hand, determine from the data available how many people attempted to stop smoking, or how many had stopped but then returned to smoking. Other studies clarified that up to half to two-thirds of those diagnosed with certain cancers, stopped smoking as a result.

Issues such as depression, unavailability of smoking cessation programs and the psychological/emotional stress involved in coping with a diagnosis of cancer represent reasons to explain why it is that some people continue to smoke, according to the study authors. In addition, though lung cancer patients are likelier to directly link tumours with tobacco, and as a result stop smoking, those with breast, bladder, anal or other cancers might not recognize any connection, thus lacking motivation to stop.

"If  you go far back many decades ago, certainly when I was in medical school, the approach was, they have cancer, you don't want to bother them right now, it's too late, there's nothing that can be done and [smoking] is a little comfort they have. Some doctors might say, 'Well, I don't do prevention. This is not about prevention -- stopping smoking is part of the treatment and it will improve the outcomes", explained Dr. Mowat.