Abstract B018: Exploring medical stigma associated with smoking experienced by African American/Black cancer patients

Abstract Significance: Health-related stigma, defined as stereotyping, discrimination, labeling and status loss associated with a health condition or behavior, can lead to poorer quality of life, delays in seeking help, increased illness-related stress, as well as other detriments to physical and psychological wellbeing. Anti-smoking campaigns have denormalized smoking, leading to the stigmatization of individuals who smoke. Medical stigma associated with smoking (MSAS) refers to smoking-related stigma experienced in healthcare settings. MSAS can lead to delays in seeking healthcare, potential delays in cancer diagnoses, worse health outcomes, poor healthcare experiences, and potentially impede smoking cessation. African American/Black patients may experience greater MSAS due to the intersectional nature of stigma. Given the numerous negative health outcomes associated with smoking, reducing MSAS is vital to improving patient experience and patient outcomes. Methods: Using Group Concept Mapping, an approach that combines qualitative group processes with statistical analyses, the patient experience of African American/Black (AA/B) cancer patients who smoke was explored. Two brainstorming sessions were held, one with patients with lung cancer and one with patients with non-smoking-related cancers. After brainstorming, participants sorted the brainstormed statements based on the meaning of the statement. Sorted data was used to create conceptual maps. Results: Eleven individuals participated in two brainstorming sessions. Participants in the brainstorming sessions made 49 statements. Twenty-one participants were invited to sort the statements using a website. Eleven individuals completed the sorting activity, sorting the statements into an average of eight piles. Participants expressed concern about being perceived as a smoker (e.g., smelling like smoke, being seen smoking) at the cancer center. Participants found FCCC staff to be supportive but had negative interactions with healthcare providers outside of their cancer care. A point map was generated through multidimensional scaling which plotted statements based on their distance from other statements. The stress value for this map was 0.18 indicating a good fit, suggesting that sorting was not done randomly. Statements that are closer together on the point map were sorted together more frequently by participants. Hierarchical cluster analysis was used to draw cluster maps over the point map to illustrate how the statements hang together conceptually. Eleven cluster maps were created and analyzed by reviewing the pile names generated and the movement of statements from cluster to cluster. Conclusion: Patients with cancer experience internalized and anticipatory stigma related to smoking. Negative, stigmatizing interactions within the healthcare system could prevent cancer patients from sharing information about their smoking status or create undue stress associated with seeking and receiving care. Understanding the experience of MSAS will provide avenues for improving care and reducing this stigma. Citation Format: Alison Brecher, Alexandra Reyes, Kelsey Lachow, Carolyn Fang, Linda Fleisher. Exploring medical stigma associated with smoking experienced by African American/Black cancer patients [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B018.