Nicotine - Effects of Messaging

For more information on stigmatizing people who smoke, please see our page about stigma.

Positive Outcomes

2024: Harnessing hope and bolstering knowledge of how to quit: a qualitative investigation of including efficacy content in tobacco risk communication via daily SMS

• "By contrast, messages that address efficacy beliefs can increase hope, knowledge of cessation supports and motivation, thus supporting adaptive responses to smoking health risks."
• Full text in PDF.
• Note this study is listed in both the positive outcomes and unintended consequences sections.
  • Citation: Lillian Brinken, Kate Shiells, Stuart G Ferguson, Stefania Franja, Anna Blackwell, Claire Braboszcz, Olivia M Maynard, Harnessing hope and bolstering knowledge of how to quit: a qualitative investigation of including efficacy content in tobacco risk communication via daily SMS, Nicotine & Tobacco Research, 2024;, ntae297, https://doi.org/10.1093/ntr/ntae297
    • Acknowledgement: This study was supported by an ESRC New Investigator‘s Award, awarded to Dr Olivia Maynard (ES/R003424/1) and Medical Research Council Integrative Epidemiology Unit at the University of Bristol (MC_UU_00011/7). Stuart Ferguson has provided expert advice to various pharmaceutical companies and has received researcher-initiated project grant funding (through the GRAND initiative) and travel funds from Pfizer. These companies are not involved in the current study. All other project team members report no conflicts of interest.

2017: Internalized smoking stigma in relation to quit intentions, quit attempts, and current e-cigarette use

• Note this study is listed in both the positive outcomes and unintended consequences sections.
• Consistent with previous research we have found that smokers’ who reported greater feelings of stigmatization about their smoking were more likely to report having made recent quit attempts and report a stronger intention quit smoking in the future.
  • Citation: O'Connor RJ, Rees VW, Rivard C, Hatsukami DK, Cummings KM. Internalized smoking stigma in relation to quit intentions, quit attempts, and current e-cigarette use. Subst Abus. 2017 Jul-Sep;38(3):330-336. doi: 10.1080/08897077.2017.1326999. Epub 2017 May 8. PMID: 28481713; PMCID: PMC6319257.
    • Acknowledgement: This work was supported by a cooperative agreement from the National Cancer Institute (U19CA157345). The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. KMC has received grant funding from Pfizer, Inc to study the impact of a hospital-based tobacco cessation intervention and also has served as an expert witness in litigation filed against the tobacco industry. The remaining authors declare they have no conflicts of interest.

Unintended Consequences

2024: Harnessing hope and bolstering knowledge of how to quit: a qualitative investigation of including efficacy content in tobacco risk communication via daily SMS

• "Participants in the present study described how GHWLs [graphic health warning labels] were experienced as stigmatising in the context of broader policies leading to denormalisation of smoking. They felt smokingrelated stigma negatively impacted their motivation to quit and confidence to do so. In light of these and other similar findings35,37, we suggest policies intended to promote denormalisation be re-considered."
• Note this study is in both the positive outcomes and the unintended consequences sections.
• Full text in PDF.
  • Citation: Lillian Brinken, Kate Shiells, Stuart G Ferguson, Stefania Franja, Anna Blackwell, Claire Braboszcz, Olivia M Maynard, Harnessing hope and bolstering knowledge of how to quit: a qualitative investigation of including efficacy content in tobacco risk communication via daily SMS, Nicotine & Tobacco Research, 2024;, ntae297, https://doi.org/10.1093/ntr/ntae297
    • Acknowledgement: This study was supported by an ESRC New Investigator‘s Award, awarded to Dr Olivia Maynard (ES/R003424/1) and Medical Research Council Integrative Epidemiology Unit at the University of Bristol (MC_UU_00011/7). Stuart Ferguson has provided expert advice to various pharmaceutical companies and has received researcher-initiated project grant funding (through the GRAND initiative) and travel funds from Pfizer. These companies are not involved in the current study. All other project team members report no conflicts of interest.

2019: The ironic effects of stigmatizing smoking: combining stereotype threat theory with behavioral pharmacology

• "Messages that elicit negative stereotypes of smokers operated as ‘smoking-promoting messages’ in the context of our controlled laboratory investigation."
• PDF of paper
  • Citation: Cortland, C. I., Shapiro, J. R., Guzman, I. Y., & Ray, L. A. (2019). The ironic effects of stigmatizing smoking: combining stereotype threat theory with behavioral pharmacology. Addiction. doi:10.1111/add.14696
    • Acknowledgement: This research was funded by a Tobacco-Related Disease Research Program (20XT-0154) grant awarded to the first and last authors. The authors would like to thank Spencer Bujarski for his assistance with the analyses.

2019: DOES IT HELP SMOKERS IF WE STIGMATIZE THEM? A TEST OF THE STIGMA-INDUCED IDENTITY THREAT MODEL AMONG U.S. AND DANISH SMOKERS

• " Consistent with the stigma-induced identity threat model (Major & O’Brien, 2005), we found that stigmatization generated a series of emotional, physiological, cognitive, and attitudinal reactions moving the smokers away from, rather than toward, quitting."
  • Citation: Helweg-Larsen M, Sorgen LJ, Pisinger C. DOES IT HELP SMOKERS IF WE STIGMATIZE THEM? A TEST OF THE STIGMA-INDUCED IDENTITY THREAT MODEL AMONG U.S. AND DANISH SMOKERS. Soc Cogn. 2019 Jun;37(3):294-313. doi: 10.1521/soco.2019.37.3.294. Epub 2019 Jun 7. PMID: 31303688; PMCID: PMC6625812.
    • Acknowledgement: The work was supported by the National Cancer Institute at the National Institutes of Health (R15-CA194937). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. The authors declare no competing interests.

2018: Smoking-Related Stigma: A Public Health Tool or a Damaging Force?

• "This study suggests that perceived smoking-related stigma may be associated with more quit attempts, but less successful quitting among smokers. It is possible that once stigma is internalized by smokers, it may function as a damaging force."
  • Citation: Lozano P, Thrasher JF, Forthofer M, Hardin J, Shigematsu LMR, Arillo Santillán E, Fleischer NL. Smoking-Related Stigma: A Public Health Tool or a Damaging Force? Nicotine Tob Res. 2020 Jan 27;22(1):96-103. doi: 10.1093/ntr/nty151. PMID: 30053141; PMCID: PMC7297009.
    • Acknowledgement: Funding for data collection came from the Mexican Consejo Nacional de Ciencia y Tecnología (Salud-2007-C01-70032), with additional funding for analysis provided by the National Cancer Institute at the National Institutes of Health (P01 CA138389), Canadian Institutes for Health Research (57897, 79551, and 115016), and GTF was supported by a Senior Investigator Award from Ontario Institute for Cancer Research and by a Prevention Scientist Award from the Canadian Cancer Research Institute.

2017: Internalized smoking stigma in relation to quit intentions, quit attempts, and current e-cigarette use

• Note this study is listed in both the positive outcomes and unintended consequences sections.
• It is also important to recognize the potential negative consequences associated with stigmatizing smokers, who may seek ways to evade stigma by segregating themselves into groups accepting of smoking and perhaps fostering the development of fatalistic attitudes about their ability to change their smoking behavior, which make quitting smoking harder to accomplish. Thus, behavioral interventions for smoking cessation might include addressing stigma-related issues as part of the quitting process.
  • Citation: O'Connor RJ, Rees VW, Rivard C, Hatsukami DK, Cummings KM. Internalized smoking stigma in relation to quit intentions, quit attempts, and current e-cigarette use. Subst Abus. 2017 Jul-Sep;38(3):330-336. doi: 10.1080/08897077.2017.1326999. Epub 2017 May 8. PMID: 28481713; PMCID: PMC6319257.
    • Acknowledgement: This work was supported by a cooperative agreement from the National Cancer Institute (U19CA157345). The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. KMC has received grant funding from Pfizer, Inc to study the impact of a hospital-based tobacco cessation intervention and also has served as an expert witness in litigation filed against the tobacco industry. The remaining authors declare they have no conflicts of interest.

2016: Smoking Cessation and the Role of Stigma: A Systematic Review

• 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.
  • Citation: Thesis - Carl White - University of St. Thomas, Minnesota
    • Acknowledgement: Contributors: Melissa Lundquist

2015: Article: Smoking stigma can hurt efforts to quit

• Public health campaigns that stigmatize smoking can backfire, according to a study published Monday, leading some people to become so angry and defensive that they refuse to quit and others feeling so bad about themselves that they give up trying.