title: Smokers are less likely than non-smokers to seek help for a lung cancer 'alarm' symptom.
abstract: The majority (>85%) of lung cancer cases are linked with smoking, and prognosis is poor because it is often diagnosed at a late stage. One contributor to late-stage diagnosis could be patient delay in help-seeking. We investigated the help-seeking behaviour of smokers and non-smokers for a recent lung cancer alarm symptom.
  
  
  
  A health survey was sent to 4913 men and women aged >50 years through through General Practice. It included questions on symptoms experienced in the past 3 months (from a checklist), help-seeking (Yes/No) for each symptom and demographic characteristics including smoking status. Univariable and multivariable binary logistic regression analyses were used to assess the association between smoking status and help-seeking for a cough or hoarseness.
  
  
  
  Among 2042 participants (42% response rate), 280 (14%) reported 'cough or hoarseness' in the past 3 months; of whom 22% were current smokers. Being a smoker was associated with reduced likelihood of help-seeking (OR 0.44; 95% CI 0.23 to 0.83), even after adjusting for demographic factors (OR 0.46; 95% CI 0.21 to 1.00).
  
  
  
  Delay in help-seeking in smokers for a symptom that is potentially indicative of lung cancer is a cause for concern. Future research could usefully address the psychological mechanisms through which help-seeking in smokers is hindered.
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Friedemann Smith
authors.affiliation: School of Health Sciences, University of Surrey, Guildford, Surrey, UK.
authors.forename: K L
authors.initials: KL
authors.lastname: Whitaker
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Winstanley
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Wardle
mesh_terms: D057210:Delayed Diagnosis; D004739:England; D005260:Female; D006306:Health Surveys; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012907:Smoking / Q000009:adverse effects*
keywords: Lung Cancer; Psychology; Tobacco and the lung