Nicotine - Stigma: Difference between revisions

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=='''Studies, Papers, Reports - Employment and Insurance'''==

=='''Studies, Papers, Reports - Employment and/or Insurance'''==

===2018: [https://psycnet.apa.org/record/2017-40480-001 A qualitative review of tobacco research related to public and structural stigma.]===

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===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.

*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.” On the other, despite eliminating health insurance practices that explicitly disadvantage people based on health, 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. 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

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**(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).

*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://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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===2008: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006698/ Smoking and the emergence of a stigmatized social status]===

*Structural forms of discrimination perpetrated against smokers and former smokers (e.g., company policies against hiring smokers) are also related to smoker-related stigma.

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=='''Articles, Websites, Blogs - Employment and/or Insurance'''==

<br>

@@ Line 131: / Line 131: @@
 <br>
-=='''Studies, Papers, Reports - Employment and Insurance'''==
+=='''Studies, Papers, Reports - Employment and/or Insurance'''==
 ===2018: [https://psycnet.apa.org/record/2017-40480-001 A qualitative review of tobacco research related to public and structural stigma.]===
@@ Line 141: / Line 141: @@
 ===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.
+*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.” On the other, despite eliminating health insurance practices that explicitly disadvantage people based on health, 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. 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
@@ Line 149: / Line 149: @@
 **(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).
+*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://ir.stthomas.edu/cgi/viewcontent.cgi?article=1647&context=ssw_mstrp Smoking Cessation and the Role of Stigma: A Systematic Review]===
@@ Line 161: / Line 161: @@
 ===2008: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006698/ Smoking and the emergence of a stigmatized social status]===
 *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>
+=='''Articles, Websites, Blogs - Employment and/or Insurance'''==
 <br>