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*'''To advance the field, it will be critical to pinpoint whether, when, and how denormalization becomes stigmatization.''' [emphasis added] | *'''To advance the field, it will be critical to pinpoint whether, when, and how denormalization becomes stigmatization.''' [emphasis added] | ||
*Removing the stigmatizing aspects of existing approaches, and creating new interventions that avoid stigmatizing smokers, may help further enhance the reach and effectiveness of tobacco control. | *Removing the stigmatizing aspects of existing approaches, and creating new interventions that avoid stigmatizing smokers, may help further enhance the reach and effectiveness of tobacco control. | ||
===2017: [https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/abs/stigmatizing-the-unhealthy/A5459EB669E1C69C9326C13915D6E379 Stigmatizing the Unhealthy]=== | |||
*[https://sci-hub.se/10.1177/1073110517750582 Sci-Hub (full paper)] | |||
*The very fact that the Affordable Care Act moved away from health status-based rating in the individual market, with conspicious exceptions for tobacco use and wellness program participation, is telling. The ACA then suffers from an internal tension. On one hand, its supporters framed it as “a civil rights bill for the sick.”33 On the other, despite eliminating health insurance practices that explicitly disadvantage people based on health,34 the ACA permits — even encourages — health insurers to charge more to people who use tobacco. Pursuant to the tobacco surcharge, an insurer can opt to charge a tobacco user up to fifty percent more for the same health plan.35 While many health insurance companies may not opt to charge the full penalty, the ones that do could price out smokers and other tobacco users. | |||
*It then comes as no real surprise that the Affordable Care Act’s tobacco surcharge may actually backfire, leading people to drop health insurance rather than to quit smoking. Given both the intervention’s ineffectiveness and its lack of a clear justification for regulating tobacco use and no other health status, we propose that singling out tobacco users may be the result of animus. | |||
*The tobacco surcharge singles out smokers and other tobacco users, thus communicating | |||
**(1) that tobacco use has social meaning as a category, | |||
**(2) that using tobacco is socially undesirable, | |||
**(3) that classifying people based on their tobacco use is acceptable, and | |||
**(4) that tobacco users should face disadvantage in the form of a heightened premiums. | |||
*In other words, the tobacco surcharge mirrors the process of stigmatization. Thus, even if the tobacco surcharge is not driven by animus against smokers, the ACA could lay the foundation for stigmatizing tobacco users. | |||
*Smokers face similar kinds of regulation outside health insurance. Some employers refuse to hire nicotine users of any kind.53 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://ir.stthomas.edu/cgi/viewcontent.cgi?article=1647&context=ssw_mstrp Smoking Cessation and the Role of Stigma: A Systematic Review]=== | ===2016: [https://ir.stthomas.edu/cgi/viewcontent.cgi?article=1647&context=ssw_mstrp Smoking Cessation and the Role of Stigma: A Systematic Review]=== | ||
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*Structural forms of discrimination perpetrated against smokers and former smokers (e.g., company policies against hiring smokers) are also related to smoker-related stigma. | *Structural forms of discrimination perpetrated against smokers and former smokers (e.g., company policies against hiring smokers) are also related to smoker-related stigma. | ||
<br> | <br> | ||
='''"Relapse"'''= | ='''"Relapse"'''= | ||
*Suggested words to use instead of relapse(d): recurrence (appears to be the most widely used), return, resume (resumption), slip, lapse, (use) episode, substance use (no strings attached to current, former, daily, random), revert, recent use... these and other suggestions can be found on this question posed on [https://twitter.com/imaracingmom/status/1519975031778033665 Twitter] in the comments. | *Suggested words to use instead of relapse(d): recurrence (appears to be the most widely used), return, resume (resumption), slip, lapse, (use) episode, substance use (no strings attached to current, former, daily, random), revert, recent use... these and other suggestions can be found on this question posed on [https://twitter.com/imaracingmom/status/1519975031778033665 Twitter] in the comments. | ||
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