Stigma in cancer: Comparing community and health professionals' acceptability of smoking and alcohol consumption

Colorectal and lung cancers are among the most common and deadly worldwide, often carrying significant stigma-especially when linked to preventable behaviors like drinking and smoking. Alcohol increases colorectal cancer risk, while smoking is the primary cause of lung cancer, leading to perceptions of self-infliction that can worsen distress, delay diagnosis, and hinder treatment. This study is the first to compare the acceptability of smoking versus drinking in cancer contexts. Using a factorial design, 132 community members and 126 healthcare professionals evaluated 72 scenarios varying by cancer type, behavior levels, diagnosis stage, post-diagnosis behavior, and activity level. Overall, drinking was viewed as more acceptable than smoking, especially among those physically active or who quit post-diagnosis. Healthcare professionals were slightly more accepting than the general public. Notably, stigma around smoking lessened at advanced cancer stages. Findings suggest the need for stigma-reducing interventions and more compassionate, nonjudgmental care in oncology settings.