Now that the National Lung Cancer Screening Program (NLCSP) is live across Australia, thousands of people at higher risk are hearing about screening for the first time. Many of them have long term smoking history, or are people who used to smoke, who may feel nervous, ashamed or undeserving of preventive care. 

This is where health professionals make the biggest impact. 

Whether you’re a GP, nurse, Aboriginal Health Worker or allied health professional, the way you talk about lung health can either open a door or close it. Stigma has long been one of the biggest barriers to participation in cancer screening and care. Reducing it is not only about kindness, but also a key part of achieving better health outcomes. 

Understanding Why Stigma Matters 

People with a history of smoking often carry emotional weight from years of judgement, shame, or discrimination. The Reducing Stigma in the National Lung Cancer Screening Program resource notes that many patients expect to feel blamed during healthcare encounters, some avoided care because of it. 

That stigma can sound like: 

  • “You did this to yourself.” 
  • “If you stopped smoking, you wouldn’t have this problem.” 
  • “You should have quit earlier.” 

Even when unintentional, these messages reinforce guilt, leading people to delay care or avoid screening. By contrast, empathy and supportive language helps patients feel respected, and more likely to engage with early detection. 

Why People Feel Judged 

There are deep reasons behind the shame many people feel about smoking; however it is important to remember: 

  • Nicotine dependence is a clinical condition, not a choice or moral failing. 
  • Many started smoking decades ago, before consistent health warnings or tobacco control laws. 
  • Tobacco marketing deliberately targeted communities, making smoking seem “normal” or even healthy. 
  • For some, smoking is tied to stress, trauma, or social connection. 

Recognising these realities helps health professionals shift from blame to understanding. 

As the program guide explains, nobody deserves lung cancer, and everyone deserves access to preventive care. 

How Language Shapes Behaviour 

The words we use have real power. Person-first, strength-based language can change how people experience healthcare and whether they return for follow-up. 

Instead of saying:  Say:
“Smoker”“Person who smokes” 
“Ex-smoker” “Person with a smoking history” 
“Non-compliant” “Unable to attend” or “Chose not to attend” or “Chose not to take the medication” 
“Nicotine addict” “Person with nicotine dependence” 
“Habit” “Dependence on nicotine” 

These changes might seem small, but they send a clear message: you see the person, not the behaviour. 

How to Have Supportive Conversations 

When you raise  lung cancer screening or smoking history, here are some practical ways to make the conversation more effective and comfortable: 

1. Start With Care, Not Judgement 

“We’re offering lung cancer screening to improve early diagnosis and treatment. It’s a way to look after your health.” 

2. Normalise Participation 

“Many people who smoke or used to smoke are eligible; it’s a routine part of preventive care.” 

3. Emphasise Choice 

“It’s completely your decision whether to take part. My role is to make sure you have the information you need to support your decision.” 

4. Acknowledge Strengths 

“It’s great that you’re thinking about this. Taking the first step shows you care about your health.” 

5. Avoid Linking Screening with Quitting 

Screening is not conditional on quitting, and that’s a vital message. 

“You don’t need to quit smoking to be screened. This program is here to help find any early signs of lung cancer.” 

By separating screening from quitting, you create space for trust, and for more meaningful future conversations about smoking cessation. 

The Role of Health Professionals in Reducing Stigma 

Health professionals are trusted voices. Every supportive interaction helps change the broader culture around lung cancer. 

You can contribute by: 

  • Modelling non-stigmatising language in your team and community 
  • Encouraging peers to take a person-first approach 
  • Using visual aids and posters that promote lung health positively 
  • Challenging assumptions about who “deserves” preventive care 
  • Sharing stories of success and survival, not blame 

When practices lead with compassion, patients feel safe to seek help. 

Understanding the Bigger Picture 

Stigma isn’t just about words; it’s also about power and equity. Lung cancer disproportionately affects people from groups who already experience discrimination, including: 

  • Aboriginal and Torres Strait Islander peoples 
  • People living in rural and remote areas 
  • People from culturally and linguistically diverse backgrounds 
  • People from LGBTIQA+ communities
  • People with disability
  • People experiencing mental health challenges

By addressing stigma, health professionals help remove one of the most persistent barriers to equitable care. 

Integrating Smoking Cessation with Compassion 

Even though quitting isn’t a requirement for screening, many patients use the screening conversation as a natural point to consider change. 

When talking about quitting: 

  • Use Ask–Advise–Help, not guilt. 
  • Offer Quitline (13 7848), or Quit 
  • Frame it as support, not pressure. 
  • Acknowledge that multiple attempts are normal. 
  • Recognise cultural and social factors, for some communities, smoking carries shared meaning or identity. 

When patients feel supported, not judged, they’re more likely to take up cessation help voluntarily. 

Why Training Matters 

The National Lung Cancer Screening Program Health Workforce Education includes a full module dedicated to effective communication strategies. 

It covers: 

  • Person-first language and stigma reduction 
  • Shared decision-making 
  • Smoking cessation conversations 
  • Cultural safety and trauma-informed care 
  • How to discuss results and eligibility with sensitivity 

Completing the training can help you and your team strengthen communication skills and ensure every conversation promotes trust and dignity. 

What’s in It for Health Professionals 

  • More meaningful patient engagement 
  • Increased screening uptake 
  • Reduced appointment anxiety and missed follow-ups 
  • Stronger continuity of care 
  • Professional confidence and CPD recognition 
  • A role in changing how society talks about lung cancer 

Reducing stigma isn’t a side issue, it’s a clinical skill that saves lives. 

If you haven’t yet completed the training, now’s the time to build your confidence in having stigma-free conversations. Register for the FREE National Lung Cancer Screening Program Health Workforce Education.

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