World Cancer Day 2025

Connectedness and Hope

May Future Memories Be Brighter Than Past Ones

Early this morning, I sat down to read a paper Mike Cummings had sent me. The words “connectedness and hope” immediately leaped off the page and grabbed my attention.

I paused and became lost in thought. Memories of when I started smoking at the age of ten brought a smile to my face—sneaking that first cigarette alone behind my grandparent’s barn. One of Gramps smokes. He was my hero, and that cigarette made me feel more connected to him. It is, after all, why I was smoking. I wanted to be like him in any way possible.

It would be a few years before most of my peers were smoking. As a kid who never fit in entirely with any of the groups in school, smoking gave me an “in” with all the other kids who smoked. It automatically made me one of them. We were the rebels, touting our independence, and we thought we were cool. There were so many of us in the 70s that my high school gave up the battle and designated specific restrooms as student smoking lounges.

As an adult, smoking kept me connected to others. Taking a smoke break with co-workers, sitting in the smoking section at a restaurant, or with a group of moms at the park sitting on a bench smoking while we watched our kids play. Even clean indoor air laws kept us connected as we huddled together outside on a blustery winter day, having a smoke together.

I tried to quit smoking many times over the decades I smoked. I knew smoking was bad for me, and I knew society wanted me to stop. But I don’t believe I ever really wanted to quit, to give up all the things I got from smoking. Besides a sense of belonging, I found smoking soothing—a way to slow down and pause for a moment. Smoking gave me something to do. I liked the visual of a plume of smoke.

Still, I tried to quit. I stopped counting the times I tried and failed. Even quitting for a brief period didn’t feel rewarding, and I always went back to smoking. After a while, it felt more shameful to fail so much than it did to be someone who smokes. I thought quitting was a hopeless endeavor, and I stopped trying.

Then came the day I watched my son almost die from a heart attack. He was only twenty-nine. That’s the day I discovered a new kind of hope. On the hour-long drive to the hospital, I hoped he’d still be alive when we got there. Once we found out he survived, there came a new hope as we hoped he’d stop smoking because smoking was going to kill him decades before he should die.

When he tried vaping, we hoped it would work to help him stop smoking. We were relieved when he succeeded and hoped he’d remain smoke-free. Then he opened a vape shop, and we hoped it would make it and we could help other people stop smoking. I hoped that no other moms would watch their child curled up in pain on the bathroom floor having a heart attack.

I finally broke away from the trip down memory lane and returned my attention to the paper I had sat down to read; “Holding on to Hope”: follow up qualitative findings of a tobacco treatment intervention for people experiencing mental health conditions.

It feels to me that we often partition people into little pieces and address individual partitions instead of focusing on the whole person. As a person living with a mental illness and neurodiversity, my lived experiences have taught me that those things affect everything in my life.

One of the things I liked about this study is that they acknowledged the whole person, not just the smoking. This part from the background section got my attention;

“The intervention condition included the same provision as the control condition, with the addition of a proactive referral to Quitline counselling based on cognitive behavioral therapy and tailored to meet the needs of people experiencing SMI, and up to 8 weeks of cNRT. Tailored Quitline counselling with a dedicated counsellor included structured monitoring of mental health symptoms, nicotine withdrawal symptoms, and medication side-effects to help distinguish temporary withdrawal symptoms from psychiatric symptoms; and a focus on psychoeducation including the relationship between smoking and mood; goal setting; identification of triggers to smoke; and facilitating problem solving and skills building, including the use of mood management strategies that also act to aid cessation.”

In genuine meeting people where they are at fashion, the paper goes on to say,

“...However, these interviews indicated that a tailored intervention had the potential to assist people on their journey to quitting while they continued their journey of mental health recovery.”

One of the things that stood out to me about this study was the inclusion of people with lived experience;

“Consumer engagement and accurate reporting of their contributions to research is an increasingly appreciated imperative in academic research. Our efforts to do this are reflected in the project by engaging peer researchers at all stages of the project. Several investigators (CB, NC, MM, TZ) were employed in consumer (or lived experience) roles and two had personal experiences of quitting tobacco smoking.”

And then went on to say,

“As multiple lived experience researchers were employed on this project, there was opportunity to discuss and explore the findings of the research from multiple lived experience lenses.”

As I read the paper, I was surprised to see some of the sentiments I had just reminisced about verbalized. How participants believed in whether or not they could quit smoking made a difference, and how some found smoking comforting. How their mental illnesses contributed to hopelessness and despair and inhibited their motivation to quit smoking.

Participants talked about not feeling supported in quit attempts by their GPs, which reminded me of the numerous times my doctors either ignored my smoking or lectured me that I should quit but didn’t offer any help or support to do so.

It made sense to me, as someone with a mental illness who smoked, why the participants valued the interactions with the peer researchers and quit counselors and how that connection made them feel less isolated and more confident. It also made sense that it could make a difference to interact with people who believe a person with a mental illness can successfully quit smoking.

I found it interesting to see how participants’ perceptions about their barriers to quitting smoking changed over time. Also interesting was the vital role that hope played by clinicians and participants.

“Like Twyman et al., the findings in this study indicate that a lack of hope or optimism on the part of clinicians can impact the quit attempts of service users. Low mood challenged the capacity of participants to see positive futures for themselves, encouraging pessimism and lack of confidence that the journey to quit smoking will be worth the effort – suggesting that lack of hopefulness may be a more significant barrier for people experiencing SMI.”

The paper then goes on to discuss the importance of connectedness and how people living with a mental illness often feel isolated and unsupported. Smoking can alleviate boredom and give them a social connection with others. Those social networks can be prone to experiencing pro-smoking norms, adding another barrier to smoking cessation.

While this study had a small sample size and had to deal with the obstacles of the COVID-19 pandemic, I found what it said to ring true with my own lived experiences with mental health challenges and smoking. It points out the importance of compassionate support with peer involvement to help more people like me successfully stop smoking.

I’ve now returned to reminiscing. I’m thinking about loved ones lost because the information found in the study and the suggested support weren’t available in time to help them stop smoking. The timing was perfect to read this paper today.

Today is World Cancer Day. It makes me think of my very good friend, Bucky, who died from lung cancer twelve years ago. He, like me, lived with depression and smoked heavily. While he was able to break free from his addiction to alcohol and lived a life of sobriety for many years, he was never able to give up smoking. Many in his AA family smoked, another bond they had that gave them a connection to others.

Today also makes me think of my Mom. Tomorrow marks thirteen years since she passed away. She had cancer, heart disease, and COPD. Her mental illness tortured her, and smoking brought her moments of calmness and relief. It was difficult for her when the COPD got so bad she could no longer smoke. She had nothing to replace what smoking gave her. She lived the last years of her life isolated and alone. Her only connection left to anything was her dog, Zeke.

Too many of us with mental health challenges smoke. We have a harder time quitting. We, just like everyone, need connectedness and hope. Not only to quit smoking but to thrive. The 2025 theme for World Cancer Day is “United by Unique.” A worldwide focus that places the person at the center of care and their stories at the heart of the conversation.

That sounds like the perfect plan to offer people who smoke and live with a mental illness a way to connect with those around them and give them hope for a future free from smoking with its increased risk of cancer.

Until next time…