Can celebrity cancer diagnoses prompt quitting smoking?

In a study published this week in Preventive Medicine, researchers from San Diego State University, the Santa Fe Institute, the University of North Carolina and the Johns Hopkins Bloomberg School of Public Health found that when celebrities publicly discuss their struggles with cancer diagnoses, the resulting media coverage prompts more smokers to search for information on quitting than events like New Year's Day or World No Tobacco Day.

Public health experts have long known these discussions spur others to get screened for cancer or consider the same treatments, but it was unclear whether these discussions also promoted cancer prevention behaviors, like quitting smoking. This question has evaded study because the method most commonly used to assess cancer-related behaviors -- annual telephone surveys -- isn't fine-grained enough to tell researchers which events are influencing respondents' answers.

The researchers, led by San Diego State University research professor John W. Ayers, investigated whether a different method might yield new insights. Using the case of former Brazilian President Lula da Silva, who was diagnosed with laryngeal cancer in October 2011 and attributed his cancer to his long-held smoking habit, the researchers analyzed both media coverage of smoking cessation and the public's online search activity surrounding the event.

By mining Google News archives, the team found Brazilian news coverage of quitting increased as much as 500 percent immediately after the diagnosis -- and remained 163 percent higher for one week -- before returning to typical levels. At the same time, Brazilian Google searches related to quitting smoking increased by 67 percent.

However, long after the media stopped covering Lula's diagnosis, the public had not forgotten. Two weeks after the diagnosis, quitting-related Google searches remained 153 percent higher than expected, and remained 130 percent and 71 percent higher three and four weeks respectively after Lula's announcement.

"Lula's announced cancer diagnosis, though tragic, was potentially the greatest smoking cessation-promoting event in Brazilian history," Ayers said. "Interest in quitting smoking, as indicated by Google searches, reached its highest recorded level after Lula's diagnosis, even when compared to traditional cessation awareness events such as New Year's Day or World No Tobacco Day."

Benjamin Althouse, the study's coauthor and Santa Fe Institute epidemiologist added, "In practical terms, we estimated there were about 1.1 million more quit-smoking queries in Brazil the month after Lula's diagnosis than expected. Not only will quitting prevent throat cancer, but it can prevent nearly all cancers, including lung, stomach, breast, etc."

The benefits don't end there. Following Lula's diagnosis, Brazilian legislators passed a number of new laws strengthening anti-tobacco measures in the country, making Brazil the largest smoke-free nation in the world, said Joanna E. Cohen, another coauthor and director of the Johns Hopkins Institute for Global Tobacco Control.

"This study is the first to demonstrate that celebrity diagnoses can prompt the public to engage in behaviors that prevent cancer," said Seth M. Noar, coauthor and health communication professor at the University of North Carolina at Chapel Hill. "Harnessing this finding will save far more lives than screening alone."

The study has a compelling lesson for tobacco control advocates, concluded Ayers: "These kinds of events act as teachable moments when the public is more receptive to messages about cancer than is ordinarily the case. When these events take place, tobacco control and cancer prevention advocates should better leverage these opportunities to promote behaviors that will prevent all future cancers."