Exploring Reactions to Risk and Uncertainty in the Context of Smoking and Lung Cancer

Research examining the sociology of diagnosis has demonstrated how the provision of a clinical diagnosis from a health professional can promote identification of illness or disease, facilitate behaviour change, and enhance adoption or resistance of illness identities (Jutel and Nettleton, 2011). Further examination of such frameworks could contribute towards achieving a richer understanding of health communication compliancy, thus enabling better management or avoidance of ill health and disease.

The current study examines such frameworks within the context of a Stop Smoking Service (FagEnds, Liverpool) and the study has been designed to replicate a recognised model of diagnosis. However, rather than a clinical diagnosis, smokers receive a personalised lung cancer risk assessment – essentially providing them with a diagnosis of uncertainty. The primary aim of this study will be to ascertain whether provision of personalised lung cancer risk information alongside health advice, will enhance smoking cessation.

This mixed-method paper will disseminate the findings of a randomised controlled study consisting of ~300 smokers, in which the control arm receive generalised lung cancer risk information and the intervention arm receive a personalised lung cancer risk assessment, using the Liverpool Lung Project risk model (Cassidy et al., 2008). It is anticipated that provision of personalised lung cancer risk information may encourage behaviour change i.e. smoking cessation and long-term maintenance of this change at six-month follow-up. In support of the aforementioned quantitative survey, qualitative interviews will also be conducted with a selection of participants (N=30), which aims to provide further explanation as to the impact of receipt of a diagnosis of uncertainty and the subsequent behaviour and attitudes of which it may entail. Overall, it is anticipated that the findings will contribute towards our understanding of the sociology of diagnosis and may help to inform the development of future health risk communications.