Should I say anything? Cancer survivor smoking.

[clearsommespace]

I was visiting DB a couple of days ago. I am convinced he is smoking in secret (hiding it from SIL). In the last three years he has been diagnosed life-threatening cancer but after some tough chemo and surgery (8 months off work) he was declared fit to return to work and is still being monitored (blood tests once a year). They have two children. Should I make it clear that I noticed? He obviously knows he is not supposed to be smoking otherwise he wouldn't be hiding it. I am in my 40s and he is my older brother.

[loveyoutothemoon]

I would definitely say something.

[clearsommespace]

Thanks all. Alot of food for thought.

[VintageTrouble]

It is bad advice life. If you stop smoking after a heart attack your risk of another drops by around 50%. If you continue smoking you double the risk of having another one.

[lifeinslowmotion]

My dad had a major heart attack in his mid 40s. His consultant told him if it would be too stressful to quit smoking he should just cut down as much as he could. I was there at the time it was said so I quite believe the same advice may be given to other patients. It's not a myth.

[FrostyNipples]

I used cannabis regularly through my treatment, recovery and after.

Not suggesting he is using drugs along with his smoke, just a thought.

Maybe he enjoys it still?

Personally I stopped smoking (fags) years ago but somehow can have a joint or 4 if I have a bad pain day without wanting a cigarette.

Let him decide where his balance is

[Pipistrella]

Totally agree

When I said tell him you know, I meant, when you are together, just say - it's Ok - you can smoke in front of me

something like that

sorry if this sounds very counter intuitive

[TouchingToes]

I've watched a few family members die from cancer and I have come to the conclusion that it doesn't matter what anyone else thinks, that it's their life/death and all you can do is let you know you love them, feel for them, and will offer any practical and emotional support that you can. If they want to smoke, drink, sunbake, eat fat.... so be it.
I think unless you have had a life-threatening illness you cannot know the sense of powerlessness, the rage, fear and worry. So no, I don't think you should broach the subject. Just be kind to your brother. (I'm sure you are.)

[Pipistrella]

Hiya

IMHO (and it is humble, because I'm not in your situation and you must be worried sick) I wouldn't try to get him to stop at all. I would tell him I knew, casually, and I'd let him do it in front of me if he wanted to - I'd be his friend about it.

It is AFAIK very hard not to smoke once you are attached to it (for want of a better word) and it must be important to him if he is continuing to do it.

Therefore I would not be trying to offer support to stop, or whatever - I'd also not be telling people about it because if he wanted them to know, he would tell them himself.

I would be there for him, smoking or not, and accept it as part of him, as it is. It's his decision and he is still the same person.

The second you start looking like you want him to stop is the second he starts feeling worse about it. And he shouldn't. And it might make it harder for him to stop if he's under pressure from you or others.

Accept it
Don't mind it (at least to his face)
Make a joke of it if you have to chastise him
Don't let it change your relationship or become the focus of conversations
Don't make it an ultimatum or a threat to tell if he doesn't stop

That would be my approach. It's a shame if he feels he can't do this thing which he wants to do, without being told off or whatever.

I bet there is no one he feels he can tell. It must be a lonely place.

[JE1234]

I'd definitely speak to him about it. Sometimes you do need someone to call you out in order to deal with something you're avoiding. If you can do it non confrontationally and because you are worried about him it will be supportive rather than meddling. He may be using it to deal with stress and not have another outlet. There's no harm in having an open chat with him and seeing if he needs any more support and if you can help him access it. I'm sure deep down he'll be more scared of another cancer diagnosis than you are. The issue can be that once someone has had an unrelated cancer they can think, "well I got it anyway, I might as well enjoy my life"- that was my DBIL's attitude but it only very thinly masked a very real and very strong fear.

[clearsommespace]

Oops that reads as if I underestimate how difficult it can be to stop smoking. I didn't mean that, more that he lacks willpower in general.

[clearsommespace]

Footie, no I meant they would blame me for not saying anything early on when it could have made a difference. I think I might blame myself which is why part of me wants to say something even though I doubt it would do much good.
Vintage, not insane but definitely lacking self-control. I don't know if you can learn that in middle-age.

[PitPatKitKat]

Clearsomespace in my family, older generation is very interventionist (genuinely out of love in many cases), younger generation is more "respect the boundaries" (perhaps unsurprisingly given interventionism). I am often in the middle sigh.

[VintageTrouble]

Just about to say that Fitzers.

He is insane if he is still smoking - I think you should ask him and explain you are concerned about him. And ask if you can support him to give up.

I say this as an ex smoker who watched my DF pass last year from lung cancer.

[Footle]

Oh sorry, OP. I thought you were implying that family members might blame you for his smoking, and I meant that they shouldn't !

[Emochild]

In my experience, the more a smoker is told they should quit, the less likely they are to actually do it

[Bakeoffcake]

My Dh was in hospital this week. The lovely Man opposite him was very poorly with cancer and had been in for weeks.
A surgeon came and said 'we've had a cancellation, we're operating today so we need to get you ready'
Nice man replied 'ok, is there time for me to go and have a smoke'
Surgeon replied 'yes of course but make it quick'
So I really think you should back off. He's a grown adult and whilst you must be worried he's gone through enough without being told off about smoking.

[Fitzers]

I thought cancer patients weren't advised to stop smoking because treatment was stressful enough.

No, that's a harmful myth. Patients will be encouraged to quit.


www.mskcc.org/blog/it-too-late-quit-smoking-if-i-have-been-diagnosed

[clearsommespace]

Pitpat, you are really good at this! You're last suggestion is perfect, if I decide to say something.

[PitPatKitKat]

Hmm, that's tricky then.

Can you skype/facetime/call/email/IM to be supportive though. Maybe at a regular time each day/week or something similar?

Some people find that kind of online support pretty helpful (e.g. some people do therapy/counselling via facetime as they find it easier to open that way). Or how about "Would you like me to help you find some extra support?" so you coudl research some local support options with him etc.

I do think that if you're not able to commit some time to supporting him, you'd be best keeping schtum. If you are worried about other family members being angry with you, they don't need to know you knew IYSWIM.

I would tread carefully about letting other family members know now, as that really isn't your call (and could come across really , really badly to your brother, but you know that anyway). However, if there is a specific family member who you think would be sympathetic and helpful to your brother, who would be able to provide the kind of in person support that is precluded in your case, then maybe mention it to them, in a hypothetical/sidling up to it kind of way.

Or you could have a conversation with your brother along the line sof "I noticed this and would love to be able to help moreethan I can...do you want some help finding support, maybe with " . If he says no, or forbids you from mentioning it to anyone, then you've got to respect that, and no family member can reasonably get angry with you.

[clearsommespace]

By the way, Quickly, I didn't mean he wouldn't know that smoking can cause cancer.
I meant that he knows that as an individual in his situation shouldn't be taking that risk.

[MissBattleaxe]

If he's doing it in secret then he already knows he shouldn't be doing it. A lecture won't stop him.

[clearsommespace]

Footie, I don't understand your post.

[clearsommespace]

Lynette I didn't know that. The treatment was about 2 yrs ago and he stopped smoking and drinking alcohol during the treatment. They came to stay with us a year ago and he definitely wasn't smoking then.

[Footle]

They'd be angry with wrong person , wouldn't they ? If they're likely to take that view, there's no reason to tell them you knew.

[clearsommespace]

Pitpat, I was thinking that something like that would be the thing to say if I say anything to him. But I live abroad, visit a couple of times a year and so I am not actually there to provide any support. So it isn't much use to let him know I know. I didn't say anything when I was staying because I thought 'it's not my call'. But now I am home it is keeping me awake at night because I wonder whether if it becomes common knowledge later down the line, other family members will be angry at me for knowing and not saying anything.