Nicotine - Stigma: Difference between revisions
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*The NCSCT has committed to using ‘people first’ language wherever possible, so instead of ‘smoker’ we will talk about ‘people who smoke’ or just ‘people’ | *The NCSCT has committed to using ‘people first’ language wherever possible, so instead of ‘smoker’ we will talk about ‘people who smoke’ or just ‘people’ | ||
====[https://www.nice.org.uk/media/default/About/what-we-do/wg1-style-guide.docx NICE style guide ] | ====2024: [https://www.nice.org.uk/corporate/ecd1/chapter/talking-about-people NICE style guide - Talking about people]==== | ||
*[https://www.nice.org.uk/media/default/About/what-we-do/wg1-style-guide.docx NICE style guide (downloadable document)] | |||
*'''Smoker: Do not use. In line with our house style, we do not label people. Use 'people who smoke'.''' [emphasis added] | *'''Smoker: Do not use. In line with our house style, we do not label people. Use 'people who smoke'.''' [emphasis added] | ||
*Don't label people with their condition: we would never say 'epileptics', 'schizophrenics', 'smokers', 'drug-takers'. Use the following as a guide: 'people with epilepsy', 'people with schizophrenia', 'people who smoke', 'people who take drugs'. | *Don't label people with their condition: we would never say 'epileptics', 'schizophrenics', 'smokers', 'drug-takers'. Use the following as a guide: 'people with epilepsy', 'people with schizophrenia', 'people who smoke', 'people who take drugs'. | ||
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*In general, refer to the person first and the disability second. People with disabilities are, first and foremost, people. Labeling a person equates the person with a condition and can be disrespectful and dehumanizing. A person isn’t a disability, condition or diagnosis; a person has a disability, condition or diagnosis. This is called Person-First Language. | *In general, refer to the person first and the disability second. People with disabilities are, first and foremost, people. Labeling a person equates the person with a condition and can be disrespectful and dehumanizing. A person isn’t a disability, condition or diagnosis; a person has a disability, condition or diagnosis. This is called Person-First Language. | ||
*However, always ask to find out an individual’s language preferences. People with disabilities have different preferences when referring to their disability. Some people see their disability as an essential part of who they are and prefer to be identified with their disability first – this is called Identity-First Language. Others prefer Person-First Language. Examples of Identity-First Language include identifying someone as a deaf person instead of a person who is deaf, or an autistic person instead of a person with autism. | *However, always ask to find out an individual’s language preferences. People with disabilities have different preferences when referring to their disability. Some people see their disability as an essential part of who they are and prefer to be identified with their disability first – this is called Identity-First Language. Others prefer Person-First Language. Examples of Identity-First Language include identifying someone as a deaf person instead of a person who is deaf, or an autistic person instead of a person with autism. | ||
====INPUD: [https://inpud.net/words-matter-language-statement-reference-guide/ Words Matter! Language Statement & Reference Guide]==== | |||
*Recommends person-first language. | |||
*"Compiled by INPUD and the Asian Network of People who Use Drugs (ANPUD), this guide aims to explain our current position on the use of language and to provide clear advice on what is acceptable to us as communities of people who use drugs. We want to encourage all people to be thoughtful about the language and words they use, and have therefore provided a reference guide that identifies stigmatising language and gives non-judgemental, strengths-based, and respectful alternatives." | |||
====Massachusetts Down Syndrome Congress - [https://mdsc.org/programs/people-first-language/ People First Language]==== | ====Massachusetts Down Syndrome Congress - [https://mdsc.org/programs/people-first-language/ People First Language]==== | ||
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=='''Videos'''== | =='''Videos'''== | ||
===2024: Breathe Easy Maine Webinar [https://www.youtube.com/watch?v=vdH__irCcY8 Addressing the Harmful Effects of Tobacco-Related Stigma]=== | |||
*Presenter: Derek Bowen, MaineHealth Center for Tobacco Independence | |||
*Stigma is the public’s effect of marking disgrace of a certain quality within a targeted community. People who use tobacco are faced with stigma and the challenges it brings day by day, and it leaves a great impact on the individual’s quality of life, mental health, and likeliness to stop using tobacco further down the road. Within the webinar, we will discuss different types of stigmas, the effects of stigma, and ways to reduce and prevent stigma when it comes to individuals who use tobacco. | |||
===2021: E-Cigarette Summit: [https://vimeo.com/572107642 Stigma and tobacco harm reduction: what we can learn from other health behaviors]=== | ===2021: E-Cigarette Summit: [https://vimeo.com/572107642 Stigma and tobacco harm reduction: what we can learn from other health behaviors]=== | ||
*[https://www.e-cigarette-summit.us.com/speaker/prof-scott-leischow/ Prof Scott Leischow] | *[https://www.e-cigarette-summit.us.com/speaker/prof-scott-leischow/ Prof Scott Leischow] | ||
*Stigmatizing smoking has been at the heart of tobacco control efforts for decades, which may drive more people to quit but at the same time potentially create new difficulties for smokers, including self-isolation, creation of social groups that might become ‘hardened’ to changing smoking behaviors, and perceptions by the user and society that complete abstinence is the only option. The stigma associated with a wide variety of behaviors has impeded progress toward improving population health in some cases, such as the reticence in making products and services available that could reduce the risk of communicable disease (eg needle exchanges), as well as harm reduction products that could benefit users and society when an individual addicted to a substance is not able to or chooses not to become completely abstinent (eg NRT, ENDS, smokeless tobacco). This presentation will explore some of the conflicting aspects of stigma in tobacco control, explore similarities and differences regarding the stigma of using of different addicting substances, and consider some research, practice and policy directions. | *Stigmatizing smoking has been at the heart of tobacco control efforts for decades, which may drive more people to quit but at the same time potentially create new difficulties for smokers, including self-isolation, creation of social groups that might become ‘hardened’ to changing smoking behaviors, and perceptions by the user and society that complete abstinence is the only option. The stigma associated with a wide variety of behaviors has impeded progress toward improving population health in some cases, such as the reticence in making products and services available that could reduce the risk of communicable disease (eg needle exchanges), as well as harm reduction products that could benefit users and society when an individual addicted to a substance is not able to or chooses not to become completely abstinent (eg NRT, ENDS, smokeless tobacco). This presentation will explore some of the conflicting aspects of stigma in tobacco control, explore similarities and differences regarding the stigma of using of different addicting substances, and consider some research, practice and policy directions. | ||
===2017: Video: [https://vimeo.com/246425657 Sarah Jakes]=== | |||
*Ecig Summit UK | |||
===[https://vimeo.com/314638943 Let's Break the Stigma]=== | |||
*How are you doing? How are you really doing? | |||
=='''Studies, Papers, Reports - Smoker'''== | =='''Studies, Papers, Reports - Smoker'''== | ||
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===2020: [https://ajph.aphapublications.org/doi/ref/10.2105/AJPH.2020.305628 Stigma, Opioids, and Public Health Messaging: The Need to Disentangle Behavior From Identity]=== | ===2020: [https://ajph.aphapublications.org/doi/ref/10.2105/AJPH.2020.305628 Stigma, Opioids, and Public Health Messaging: The Need to Disentangle Behavior From Identity]=== | ||
*"Indeed, an oft-spoken proverb among those who work in tobacco control is''' “There is no such thing as | *"Indeed, an oft-spoken proverb among those who work in tobacco control is''' “There is no such thing as a ‘smoker,’ there are only people who smoke." '''This framing intentionally creates space to decouple behavior from identity, so that unhealthy behavior (i.e., smoking) can be actively denormalized without perpetuating stigma against those who engage in it. It underscores that individuals who smoke maintain their core humanity and value as human beings, despite engaging in a socially unacceptable behavior. Once they change this target behavior, they are no longer targeted for disapproval." [emphasis added] | ||
===2020: [https://facesandvoicesofrecovery.org/wp-content/uploads/2020/06/Zgierska-2020-JAM-Language_Matters52.pdf Language Matters: It Is Time We Change How We Talk About Addiction and its Treatment]=== | ===2020: [https://facesandvoicesofrecovery.org/wp-content/uploads/2020/06/Zgierska-2020-JAM-Language_Matters52.pdf Language Matters: It Is Time We Change How We Talk About Addiction and its Treatment]=== | ||
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=='''Editorials, Articles, Websites, Blogs - Smoker (Some from Journals)'''== | =='''Editorials, Articles, Websites, Blogs - Smoker (Some from Journals)'''== | ||
===2025: Nicotine and Tobacco Research: Editorial: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntaf003/7944756 Person-First Language in Nicotine and Tobacco Research]=== | |||
*Click on "PDF" to read the editorial | |||
*"Embracing person-first language is a crucial step toward scientific precision in language use, and will help to achieve an equitable and respectful approach to research on nicotine and tobacco use. By prioritising the individual over their behaviour, we as a research community can foster a culture of linguistic accuracy and precision, which also demonstrates empathy and understanding towards those who use nicotine or tobacco containing products." | |||
===2024: International Journal of Drug Policy: Editorial: [https://www.sciencedirect.com/science/article/pii/S0955395924002007 Guiding principles for breaking down drug-related stigma in academic writing]=== | ===2024: International Journal of Drug Policy: Editorial: [https://www.sciencedirect.com/science/article/pii/S0955395924002007 Guiding principles for breaking down drug-related stigma in academic writing]=== | ||
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*Smokers face similar kinds of regulation outside health insurance. Some employers refuse to hire nicotine users of any kind. As one set of authors explain, workplace bans, “by sanctioning discrimination, abrogate smoker’s rights as ‘ordinary citizens’ by placing ‘them’ in a category that separates smokers from ‘us’(non-smokers). | *Smokers face similar kinds of regulation outside health insurance. Some employers refuse to hire nicotine users of any kind. As one set of authors explain, workplace bans, “by sanctioning discrimination, abrogate smoker’s rights as ‘ordinary citizens’ by placing ‘them’ in a category that separates smokers from ‘us’(non-smokers). | ||
===2016: [https:// | ===2016: [https://researchonline.stthomas.edu/esploro/outputs/graduate/Smoking-Cessation-and-the-Role-of/991015131652903691 Smoking Cessation and the Role of Stigma: A Systematic Review]=== | ||
*What emerged from this review is current anti-smoking campaigns are not effective for smokers who are living in poverty. These findings suggest that anti-smoking campaigns need to limit stigma and build programs that are effective for all socio-economic classes. | *What emerged from this review is current anti-smoking campaigns are not effective for smokers who are living in poverty. These findings suggest that anti-smoking campaigns need to limit stigma and build programs that are effective for all socio-economic classes. | ||
*Anti-smoking campaigns have been used for the last three decades, and while there has been a decrease in smokers across the US, the number of smokers living in poverty has remained relatively unchanged. The research points to the use of stigma as a possible reason for smokers who are living in poverty to not stop smoking. The use of stigma to help a population, who may be stigmatized for multiple reasons, has shown through the research, to be a poor tool in moving them towards a smoke free life. The use of stigma in public health campaigns may lead to making things worse for smokers who live in poverty through discrimination in hiring policies and other unintended consequences. | *Anti-smoking campaigns have been used for the last three decades, and while there has been a decrease in smokers across the US, the number of smokers living in poverty has remained relatively unchanged. The research points to the use of stigma as a possible reason for smokers who are living in poverty to not stop smoking. The use of stigma to help a population, who may be stigmatized for multiple reasons, has shown through the research, to be a poor tool in moving them towards a smoke free life. The use of stigma in public health campaigns may lead to making things worse for smokers who live in poverty through discrimination in hiring policies and other unintended consequences. | ||
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='''Lessons Learned: Substances, Alcohol, Incarceration, Illnesses, Disabilities, Mental Health, Weight, etc.'''= | ='''Lessons Learned: Substances, Alcohol, Incarceration, Illnesses, Disabilities, Mental Health, Weight, etc.'''= | ||
==''' | =='''Studies, Papers, Reports - Language/Stigma'''== | ||
===[https:// | ===2024: [https://onlinelibrary.wiley.com/doi/full/10.1002/jaoc.12137 Person-first language and addiction literature: The presence of labeling and emotional language in counseling articles]=== | ||
* | *"The purpose of this study was to determine the rate and frequency of labeling language, emotional language, and person-first language (PFL) toward individuals with substance use disorders and addictions in articles published in 24 counseling journals. Of the 249 articles reviewed, 61.04% did not fully adhere to PFL, while 34.54% included labeling language and 51.41% included emotional language. A significant positive correlation was found between the use of labeling language and emotional language. Implications for practicing counselors, counselor educators, and researchers are provided. We advocate for the use of PFL toward those with addictions in published works and in conversations." | ||
== | ===2024: [https://www.sciencedirect.com/science/article/pii/S2772724624000210 Substance use stigma: A systematic review of measures and their psychometric properties]=== | ||
*"Stigma, defined as societal labeling and mistreatment based on perceived differences (Link and Phelan, 2001) leads to a divisive “us” versus “them” dynamic that leads to status loss in a context of power dynamics. Substance use stigma (SUS) involves negative stereotypes and discrimination toward people that use substances, which results in limiting their access to needed resources and impeding wellbeing (Livingston et al., 2012). Stigma is pervasive in society and based out of moral judgments that substance use is bad or wrong (Room, 2005)." | |||
*"SUS significantly hinders treatment and education, adding to the burden carried by people with substance use disorders (Keyes et al., 2010, Kulesza et al., 2013). It limits access to treatment through underfunding of substance use treatment services (Saloner et al., 2014, Zemore et al., 2021, Calabrese et al., 2016, Luoma, 2010) and creates barriers to reintegrating into communities (Neale et al., 2011)." | |||
===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0889855323000869 Language Frames and Shapes the Response to Obesity]=== | ===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0889855323000869 Language Frames and Shapes the Response to Obesity]=== | ||
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*Creating a stigma-free health system will require collaborative action and sustained commitment of key players across the health system. | *Creating a stigma-free health system will require collaborative action and sustained commitment of key players across the health system. | ||
*Efforts to reduce substance use stigma within the health system must also acknowledge and address intersecting stigmas, including through initiatives not traditionally labelled as “anti-stigma interventions”. | *Efforts to reduce substance use stigma within the health system must also acknowledge and address intersecting stigmas, including through initiatives not traditionally labelled as “anti-stigma interventions”. | ||
===2019: [https://gh.bmj.com/content/4/5/e001911 Why we should never do it: stigma as a behaviour change tool in global health]=== | |||
*Shame-induced stigma most damages those already vulnerable, reinforcing health disparities. | |||
*Global health use of shaming tactics can inadvertently worsen health-damaging stigma, especially for those with the least power. | |||
*These effects, that drive additional health disparities and suffering, are difficult to prevent. | |||
*Ethically and practically, stigma should never be deployed as a global health tool because the effects are often both unavoidable and invisible to outsiders. | |||
===2019: [https://www.cpha.ca/sites/default/files/uploads/resources/stbbi/language-tool-e.pdf LANGUAGE MATTERS Using respectful language in relation to sexual health, substance use, STBBIs and intersecting sources of stigma]=== | ===2019: [https://www.cpha.ca/sites/default/files/uploads/resources/stbbi/language-tool-e.pdf LANGUAGE MATTERS Using respectful language in relation to sexual health, substance use, STBBIs and intersecting sources of stigma]=== | ||
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=='''Articles, Websites, Blogs - Language/Stigma'''== | =='''Articles, Websites, Blogs - Language/Stigma'''== | ||
===2024: [https://shameandmedicine.org/what-is-the-difference-between-shame-and-stigma/ What is the Difference Between Shame and Stigma?]=== | |||
*Identifying a condition as ‘stigmatising’ can show us how living with this condition can lead to negative social experiences such as discrimination, judgement, social exclusion, vilification, ostracism, labelling, loss of status, prejudice, unfair treatment, among others. | |||
*It is important to understand shame because it is shame that drives behaviour and decision-making, and in healthcare contexts, shame can easily lead to disengagement, non-disclosure, lying, withdrawal and avoidance. | |||
===2023: [https://www.apaservices.org/advocacy/news/addiction-related-federal-agencies Names of addiction-related federal agencies are changing]=== | ===2023: [https://www.apaservices.org/advocacy/news/addiction-related-federal-agencies Names of addiction-related federal agencies are changing]=== | ||
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=Suggestions to add to this page= | =Suggestions to add to this page= | ||
=== | ===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675843/ Validity and Reliability of the Internalized Stigma of Smoking Inventory: An Exploration of Shame, Isolation, and Discrimination in Smokers with Mental Health Diagnoses]=== | ||
===[https:// | ===2025: [https://www.linkedin.com/pulse/nonprofit-jargon-divides-here-words-use-jzsve/ Nonprofit Jargon Divides. Here Are Words to Use Instead.]=== | ||
=== | ===2021: [https://pmc.ncbi.nlm.nih.gov/articles/PMC8992888/ Avoiding Ableist Language: Suggestions for Autism Researchers]=== | ||
===1987: [https://sci-hub.wf/10.1086/228672 The Social Rejection of Former Mental Patients: Understanding Why Labels Matter]=== | ===1987: [https://sci-hub.wf/10.1086/228672 The Social Rejection of Former Mental Patients: Understanding Why Labels Matter]=== | ||
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===2022: [https://vimeo.com/showcase/9893575/video/779678704 Clive Bates at E-Cig Summit 2022]=== | ===2022: [https://vimeo.com/showcase/9893575/video/779678704 Clive Bates at E-Cig Summit 2022]=== | ||
*Ontology - Stigmatizing labels. The difference between addiction and dependence. | *Ontology - Stigmatizing labels. The difference between addiction and dependence. | ||
===2017: [https://pubmed.ncbi.nlm.nih.gov/28553905/ Decreasing Smoking but Increasing Stigma? Anti-tobacco Campaigns, Public Health, and Cancer Care]=== | ===2017: [https://pubmed.ncbi.nlm.nih.gov/28553905/ Decreasing Smoking but Increasing Stigma? Anti-tobacco Campaigns, Public Health, and Cancer Care]=== | ||