title: Guilt, censure, and concealment of active smoking status among cancer patients and family members after diagnosis: a nationwide study.
abstract: OBJECTIVE
  We aimed to identify the prevalence of feelings of guilt, censure, and concealment of smoking status among cancer patients and their family members who continued to smoke after the patient's diagnosis.
  
  
  METHODS
  Among 990 patient-family member dyads, 45 patients and 173 family members who continued to smoke for at least 1 month after the patients' diagnoses were administered questions examining feelings of guilt, censure, and smoking concealment.
  
  
  RESULTS
  Most patients who continued to smoke reported experiencing feelings of guilt toward their families (75.6%) and censure from their family members (77.8%), and many concealed their smoking from their family members (44.4%) or healthcare professionals (46.7%). Family members who continued to smoke also reported feelings of guilt with respect to the patient (63.6%) and that the patient was critical of them (68.9%), and many concealed their smoking from the patient (28.5%) or healthcare professionals (9.3%). Patients' feeling of guilt was associated with concealment of smoking from family members (55.9% vs. 10.0%) or health care professionals (55.9% vs. 20.0%). Family members who reported feeling guilty (36.5% vs. 16.3%) or censured (34.5% vs. 16.7%) were more likely to conceal smoking from patients.
  
  
  CONCLUSIONS
  Many patients and family members continue to smoke following cancer diagnosis, and the majority of them experience feelings of guilt and censure, which can lead to the concealment of smoking status from families or health care professionals. Feelings of guilt, censure, and concealment of smoking should be considered in the development and implementation of smoking cessation programs for cancer patients and family members.
authors.affiliation: Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea; Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul, Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.forename: Jong Hyock
authors.initials: JH
authors.lastname: Park
authors.forename: So Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Eal Whan
authors.initials: EW
authors.lastname: Park
authors.forename: Hyung Kook
authors.initials: HK
authors.lastname: Yang
authors.forename: Eunmi
authors.initials: E
authors.lastname: Ahn
authors.forename: Seon Mee
authors.initials: SM
authors.lastname: Park
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Lee
authors.forename: Myong Cheol
authors.initials: MC
authors.lastname: Lim
authors.forename: Hong Gwan
authors.initials: HG
authors.lastname: Seo
mesh_terms: D000328:Adult; D000368:Aged; D008192:Deception; D005190:Family / Q000523:psychology*; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data
keywords: cancer; censure; concealment; guilt; oncology