The impact of smoking status on anticipated stigma and experience of care among smokers and ex-smokers with chronic illness in general practice

Objectives To compare self-reported levels of 'anticipated' stigma and experience of care in general practice between current and ex-smokers living with COPD, other chronic illnesses, or those with no chronic conditions. Methods Participants completed an online survey, advertised through social media, about their experience of care from general practitioners (GPs) in the past 12 months. Respondents self-reported doctor-diagnosed chronic illnesses. Experience of care and anticipated stigma was assessed using validated questions. Multi-nominal regressions were used to determine independent effect of smoking status on anticipated stigma and other indicators of patient experience in primary care. Results Patients with COPD (n = 161) reported significantly higher anticipated stigma scores compared to those with other chronic conditions (n = 225) and this was strongly related to delayed or avoidance in seeking help from a GP when needed. This relationship remained irrespective of current smoking status. There was no difference between groups for relational components of experience of care. Discussion Primary care patients living with COPD reported worse experience of care across several domains and were more likely to anticipate experiencing stigma in the GP setting irrespective of their current smoking status compared to those with other chronic illnesses or no chronic illnesses.

Automated summary

This study compared the experiences and anticipated levels of social stigma in general practice between smokers and ex-smokers with chronic obstructive pulmonary disease (COPD), other chronic illnesses, or no chronic conditions. The results showed that patients with COPD reported higher levels of anticipated stigma and were more likely to delay or avoid seeking help from a general practitioner when needed. This relationship remained regardless of current smoking status. Patients with COPD also reported worse experiences of care compared to those with other chronic illnesses or no chronic illnesses.