Attributions of lung cancer: my own illness is hardly caused by smoking.

People experiencing unexpected negative events tend to cope with the situation through causal attributions. It seems that having some sort of answer to 'why-me' makes the event less shattering and the world more controllable. We know for example that the great majority of women with breast cancer tend to have clear ideas about its causes. Lung cancer, in contrast to breast cancer, has a well-known significant cause, as smoking accounts for about 80% of the incidences. This paper deals with the attribution process in lung cancer. It examines how lung cancer patients attribute the cause of their disease and how this relates to an understanding of how people deal with strain. Twenty-three patients with advanced non-small cell lung cancer were consecutively followed by means of repeated interviews throughout the course of the disease. It emerged that among the smokers the most common attribution was 'don't know'--smoking was not seen as the prime cause of their cancer. This finding is discussed in relation to the few earlier, somewhat contradictory studies that exist; and it is argued that the findings coincide well with the concept of 'disavowal', which is deemed to be the central process concerned in dealing with strain. Copyright 2006 John Wiley & Sons, Ltd.