Continued family smoking after lung cancer diagnosis: The patient's perspective

Purpose/Objectives: To explore the influence of lung cancer diagnosis on interpersonal dynamics in families in which one or more members continue to smoke following diagnosis. Research Approach: Descriptive, qualitative. Setting: Three cancer care sites in western Canada. Participants: 16 participants from 8 family dyads. Methodologic Approach: Patients with lung cancer receiving treatment and immediate family members were recruited to participate in individual or conjoint semistructured interviews. Thematic analysis was conducted on transcribed interviews. Main Research Variables: Intrafamily interaction patterns, smoking and smoking cessation, lung cancer diagnosis. Findings: Following diagnosis, patients with lung cancer experienced considerable distress as they struggled to understand family members' continued smoking. Patient orientations to family members who smoked included preserving relationships (maintaining harmony and connection with family members took priority over directly intervening with smokers) and risking relationships (patients repeatedly confronted family members about continued smoking to influence their cessation despite the impact on relationships). Neither pattern was successful in engaging relatives in smoking reduction or cessation, and the risking relationships approach resulted in conflict and strained family relationships. Conclusions: The findings provide additional support for examining family dynamics related to tobacco reduction and cessation as well as directions for future research. Interpretation: Nurses should encourage tobacco reduction as a supportive intervention for patients with lung cancer and their families to eliminate smoking-related distress.