Lung Cancer Smoker's Guilt

Coping With Guilty Feelings for Smokers With Lung Cancer

man looking sad and guilty
How to cope with guilt about smoking when you have lung cancer.

Lung cancer smoker’s guilt can add yet another emotion to the roller coaster of a lung cancer diagnosis. On top of the rigors of treatments and fears about the future, guilt and shame about smoking can invade your thoughts, causing anxiety and depression. It is important to address and find a way to cope with smoker’s guilt, so you can place your attention where it is needed now –- on becoming as healthy as possible.

While there is clearly a stigma about lung cancer, many of us are our own worst enemies, judging ourselves far more harshly than the rest of the world does. At the same time, when we are kind to ourselves, others often respond in a similar way.

Why Do People Experience Lung Cancer Smoker’s Guilt?

It is normal to feel guilty when you are first diagnosed with lung cancer if you have smoked. And the comments from people around you probably don’t help. How many people have responded to hearing that you have lung cancer with the phrase "How long did you smoke?" But you aren’t alone. Most people diagnosed with cancer think about the possible causes and wonder if they could have done things differently.

It is also normal to feel angry. Angry at yourself, angry at people who make insensitive comments, angry at those who look at you with that "I told you so" gaze, even angry at government and industry for allowing tobacco to exist in the first place.

Studies have shown that people who have smoked and develop lung cancer experience higher levels of guilt, shame, anxiety, and depression than those with other forms of cancer. The clear connection and public awareness of the connection between smoking and cancer most likely underlies this. The connection between other causes of cancer, such as obesity and a sedentary lifestyle, are less publicized, and we seem to be less judgmental and more supportive towards people who develop other forms of cancer.

The Danger of Lung Cancer Smoker’s Guilt

We know intuitively that guilt and shame are not healthy. Dwelling on could have, would have, and should have thoughts is anxiety-producing and stressful. No matter what we do, we can’t change the past. Though the effect of guilt and shame hasn’t been evaluated in-depth for people living with lung cancer, one study did suggest that stress is correlated with a higher mortality rate.

But the danger of lung cancer smoker’s guilt can go even beyond the emotional toll it takes. Due to the stigma, some people have hidden their diagnosis, fearing that they will be judged as causing their disease. Others have held off on seeking medical attention, fearing that insurance won’t cover a "self-inflicted" illness.

Living with Lung Cancer Smoker’s Guilt

The past is gone. It’s important to focus your efforts on your treatment now so you can be as healthy as possible today. Guilt doesn’t help anyone get better. Accept yourself. Forgive yourself. I know it’s easy for me to write these words, and smoker’s guilt won’t just vanish overnight, so here's a few tips:

Tips for Coping With Guilt About Smoking

  • Talk about it.
    Expressing your feelings and talking about any guilt you feel can be very healing. Find a loved one or friend that you feel comfortable sharing with – someone who allows you to share fully without interrupting or telling you it’s okay (in your heart it’s not okay yet if you need to talk about it). And someone who won’t add to your guilty feelings, but instead help you release them.
  • Remind yourself that you can’t change the past.
    When those thoughts step in, remind yourself that you smoked in the past. You can’t go back. But today you can focus on doing healthy things to take care of yourself.
  • Remember that smoking is legal!
    You haven’t done anything illegal. Anyone over the age of 18 can freely purchase tobacco products.
  • Consider joining a support group
    Finding support from other people with lung cancer who smoked can be very helpful for some people. You might also learn ways they have found to cope with the guilt and focus on living today.
  • Remember that you are not alone – even among non-smokers.
    Nobody is perfect. Some of us don’t smoke, but that doesn’t mean we don’t drive too fast at times, eat unhealthy food or too much food, stay out in the sun too long, or bask in sedentary behaviors that are risk factors just the same.
  • Remind yourself that cancer isn’t your fault.
    Many people smoke and never develop cancer. Nobody should blame themselves or someone else for developing cancer.
  • Remind yourself that many strong people have smoked.
    Think of people in your life that you admire, but likewise struggled with the smoking habit. Smoking is a very powerful addiction. Check out Famous People With Lung Cancer.
  • Remember that smoking was at one time considered sophisticated and fashionable.
    And, not only was it sophisticated but in 1927, 10,000 physicians actually recommended smoking cigarettes for health.
  • If you still struggle with smoking, seek out help.
    Continued smoking after a diagnosis of lung cancer can make treatments less effective and may lower survival. Our Guide to Smoking Cessation has some great tips to get you started.
    Your Quit Smoking Toolbox
  • Forgive yourself.
    Just as you would forgive someone else in your position, forgive yourself. None of us can maintain good relationships with others without practicing forgiveness regularly. Be as kind to yourself as you would be to others.

Here are some great tips on forgiving yourself and letting go of stressful thoughts:


Barni, S. et al. Guilty feeling in smokers with lung cancer: A psychological study. Journal of Clinical Oncology. 2008. Vol 26, Issue 15S (May 20 Supplement). 20642.

Chida, Y. et al. Do stress-related psychosocial factors contribute to cancer incidence and survival?. Nature Clinical Practice. Oncology. 2008. 5(8):466-75.

Dirkse, D., Lamont, L., Li, Y. et al. Shame, guilt, and communication in lung cancer patients and their partners. Current Oncology. 2014. 21(5):e718-22.

LoConte, N. et al. Assessment of guilt and shame in patients with non-small-cell lung cancer compared with patients with breast and prostate cancer. Clinical Lung Cancer. 2008. 9(3):171-8.

Raleigh, A. A Biopsychosocial Perspective on the Experience of Lung Cancer. Journal of Psychosocial Oncology. 2010. 28(1):116-125.

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