Lung Cancer Smoker's Guilt: Tips for Coping

man looking sad and guilty for smoking now that he has 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 is responsible for 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 Dangers

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.


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. It's easy to write these words, and smoker’s guilt won’t just vanish overnight, so here are a few tips.

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 that 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. Who do you know in your life who is a good listener? Often times, the most helpful person is a friend who can listen and doesn't feel she needs to jump in and try to "fix things."

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. We have all done things we wish we hadn't done and we all have regrets. But spending time rehearsing those regrets takes time away from what we can do today.

Remember That Smoking is Legal

You haven’t done anything illegal. Anyone over the age of 18 can freely purchase tobacco products. On top of that, it's very addicting. In fact, nicotine is considered to be more addictive than alcohol or even heroin.

Consider joining a Support Group

Lung cancer support groups and communities can be a wonderful way to obtain support, and fortunately, most people in these communities avoid the inherent question, "How long did you smoke." 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. Cancer begins when a single cell goes awry. It is not a punishment.

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.

Remind Yourself That Smoking Was Once 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, Seek Out Professional Help

Continued smoking after a diagnosis of lung cancer can make treatments less effective and may lower survival.

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.

Practice Self Compassion and Good Self Care

You can't change the past, but you can begin to care for yourself emotionally and physically today.

A Word From Verywell

Smoker's guilt can be hard to handle, especially when added to the stigma of lung cancer and the inevitable questions about whether you smoked or how long you smoked. As you heal your own guilt, it might be helpful to brainstorm some ways to cope with the questions you will get. These question are actually a great way to educate people. Lung cancer can and does occur in people who have smoked. But more importantly, every single person who develops cancer, whether they have smoked or not, deserves kindness, compassion, and the best medical care available.

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