Where There's Smoke, There's Stigma? Written Expressions About Individuals with Lung Cancer Reveal Cultural and Language Differences

We investigated how Australians and Hong Kong Chinese respondents describe individuals with lung cancer, examining the impact of culture and language on public discourse and stigma expression. A total of 303 participants (N_Aus = 176; N_HK = 127) were recruited from a commercial panel provider to complete an online survey. Participants were presented with a vignette describing a hypothetical lung cancer patient and asked to provide their impressions through open-ended written responses. Content coding revealed seven main themes: Warmth, Competence, Morality, Bad luck, Poor health behaviors, Ordinary, and No judgments, with both similarities and differences in participants’ written expressions across cultures. The language Hong Kongers used to respond influenced response patterns, with English responses resembling Western norms of Australians. These findings demonstrate how both culture and the language a person uses influence how people express stigma. By understanding these cultural nuances public health strategies can better support people from diverse backgrounds.