Nicotine - Stigma: Difference between revisions

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=='''Publication Policies/Author Guidelines - Person-First Language (PFL)'''==

====2021: ACS/ACS CAN: [https://www.cancer.org/content/dam/cancer-org/online-documents/en/pdf/flyers/health_equity_inclusive_language_writing_guide.pdf Inclusive Language and Writing Guide]====

*"However, people-first language does not invalidate how people may choose to self-identify. It provides a broader conceptualisation which reduces the potential for stigma, resists tobacco industry narratives and promotes greater precision and accuracy, as well as creating space which recognises these self-claimed identities can change."

====[https://www.sciencedirect.com/journal/advances-in-nutrition/publish/guide-for-authors ''Advances in Nutrition'']====

====[https://academic.oup.com/cid/pages/Manuscript_Preparation ''Clinical Infectious Diseases'']====

*Authors should use inclusive and person-first language in manuscripts. Describe people as having a condition or disease, experiencing a circumstance, or doing something specific rather than the condition, disease, circumstance, or activity being part of their identity. For example, they should use “people with obesity,” “person with HIV,” “person who injects drugs,” and so forth, rather than “obese people” “HIV positive” or “drug user.”

====[https://www.sciencedirect.com/journal/current-developments-in-nutrition/publish/guide-for-authors ''Current Developments in Nutrition'']====

**“person living with a mental health condition” instead of “mentally ill.”

**“person with a substance use disorder” instead of “addict.”

====[https://journals.sagepub.com/author-instructions/SAJ ''Substance Abuse''] (2024 changing to ''Substance Use and Addiction Journal'')====

*Strongly recommends the use of “people-first language”

*"...“smoker” replaced with person-first language such as “person who smokes.”

*So, is person-first language objectively superior to nonperson-first language? An increasing body of research suggests that it is. Many of the diseases and conditions frequently used to stand in for a person with the condition are those in which there is an unstated or even explicit implication that lifestyle choices are responsible for the condition (alcoholic, addict, diabetic, cirrhotic) or otherwise telegraph shame directed at the patient with the diagnosis (obese, epileptic, smoker). Using person-first language promotes respect and dignity for patients. Describing someone as “a patient with diabetes” rather than “a diabetic” acknowledges that the person is more than just their illness and recognizes their individuality. Using person-first language also helps to avoid stigmatization and discrimination, which can have a negative impact on a patient’s mental and physical well-being (Diabetes Spectr 2018;31:58-64). This may be especially true for mental health conditions, substance use disorders, painful syndromes, eating or body image-related conditions, and in obstetric care (Int J Drug Policy 2010;21:202-7).

*Instead of this… "Smokers," Try this... "People who smoke"

*Use person-first language. Avoid labeling people as “smokers” or “tobacco users.” Instead, start with people, then add any necessary qualifiers: people who smoke, people with a dependence on nicotine.

*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’

*Use person-first language (“person who smokes” not “smoker”).

*Instead of: smoker (e.g., patient is a smoker)

**Use: smokes (e.g., patient smokes cigarettes)

*STR’S COMMITMENT TO NON-STIGMATIZING LANGUAGE IN LUNG CANCER CARE

*"Whether we as chest imagers realize it or not, our very language can have a negative impact on the care for the patients we serve. As published studies continue to demonstrate, smoking-related language bias often stigmatizes our patients with a smoking history and results in suboptimal care and less than desirable clinical outcomes... Instead of a report stigmatizing the patient as a “smoker,” consider describing the patient as a “person who smokes.” Rather than a “nicotine addict,” an expression such as a “person with a nicotine dependence” attenuates the common stigmatization of these patients. One will notice these alternative descriptors utilize a person-first approach rather than a habit-based one. This approach can and should be adopted in publications, society and conference presentations as well as in daily training with residents and fellows. Ultimately, this language shift more precisely aligns itself with a core underpinning of our approach to care – respect for our patients.  

*It can be tempting to dismiss these kinds of negative labels as simply semantics, but research has shown that language matters. Using person-first language like “people who smoke” instead of “smokers” acknowledges the tenacity of this disease, conveys dignity and greater respect, and can reduce smoking-related stigma.

*All communications materials aimed toward potential and enrolled LCS participants must be created sensitively and incorporate the plain English guidelines to be accessible to those with low levels of health literacy. This includes clear, short sentences that use active verbs. It is also important to avoid stigmatizing language, as this can affect the care provided to patients, impact the attitude of other health care providers towards the patient, and can adversely impact health outcomes. Therefore, language used within such materials – from promotion materials to results letters – must aim to reduce the burden of stigma already experienced by these high-risk populations.  

*As part of a communications strategy, the International Association of Lung Cancer (IALSC) Language Guide should be adopted across all communications tools and resources and be included as part of HCP education and training.

***End stigma. For example, instead of “smoker” use “person who smokes.”

***Equity. Follow best practices regarding race, ethnicity, gender, socioeconomic, and geographic descriptions to promote cultural humility and sensitivity.

=='''Publication Policies - Language (General)'''==

*Hearing "smoker" a lot....at @healthvermont we prefer "person who uses tobacco" or "tobacco user" to remove the stigma, and use people-first language.

===2022: [https://ash.org.uk/wp-content/uploads/2022/05/ASH-Housing-LIN-Smoking-and-Social-Housing-May-2022.pdf Smoking and social housing from LIN and ASH]===

*"Some '''people who smoke''' choose to try e-cigarettes to help them stop smoking. Stopping smoking clearly has well-documented health benefits...People who have already switched completely from smoking to e-cigarettes should not switch back to smoking (either solely or along with e-cigarettes), which could expose them to potentially devastating health effects."

===2023: [https://www.sciencedirect.com/science/article/pii/S0376871623012711 How has the brain disease model of addiction contributed to tobacco control?]===

*[https://sci-hub.st/10.1002/casp.896 Full Study on Sci-Hub]

===2015: [https://www.fredhutch.org/en/news/center-news/2015/11/smoking-stigma-backfires-hurts-efforts-quit.html Smoking stigma can hurt efforts to quit]===

*Smokers reported feeling shame, guilt and embarrassment for their smoking behavior and used words such as “leper,” “outcast,” “bad person,” “low-life” and “pathetic” to describe themselves, the study found. These feelings increased after failed attempts to quit smoking.

===2023: [https://www.virginiamercury.com/2023/03/14/youngkin-says-he-will-sign-legislation-ending-higher-insurance-premiums-for-tobacco-users/ Youngkin says he will sign legislation ending higher insurance premiums for tobacco users ]===

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

='''"Relapse"'''=

*Our language activates implicit cognitive scripts that give meaning to what we try to convey and communicate.

=='''Videos'''==

*How are you doing? How are you really doing?

===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0889855323000869 Language Frames and Shapes the Response to Obesity]===

===2017: [https://publications.aap.org/pediatrics/article/140/6/e20173034/38277/Stigma-Experienced-by-Children-and-Adolescents Stigma Experienced by Children and Adolescents With Obesity]===

*Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth.  

===2014: [https://iep.utm.edu/pejorati/ Pejorative Language]===

*"The use of labels is one way stigma is perpetuated by eliciting the label's stereotyped narratives onto an individual or group. Within harm reduction discourse, the word "addict" can have detrimental effects on how the public perceives people experiencing addiction and their deservingness of pragmatic services. This article aims to draw attention to the inattention we give "addict" in language and explain how its routine use in society acts to perpetuate addiction stigma. Using the example of supervised injection site opposition in Canada, the use of "addict" is used as a way to understand how stigma through language works to impede the expansion of harm reduction initiatives."

===2023: [https://www.apaservices.org/advocacy/news/addiction-related-federal-agencies Names of addiction-related federal agencies are changing]===

===2023: [https://filtermag.org/samhsa-abuse-budget/?utm_source=twitter&utm_medium=social&utm_campaign=filter SAMHSA Eyes Budget Boost—and Cutting “Abuse” From Its Name]===

*“Abuse” is an ugly word. “Child abuse,” “sexual abuse,” “physical abuse,” “emotional abuse,” “domestic abuse.” And then, of course, there’s “substance abuse.”But one of those things is not like the others: In all of the other types of abuse, there is a perpetrator who is harming a victim.

===2021: [https://peoplefirstcharter.org/ People First Charter]===

*The People First Charter launched in July 2021, during the Berlin International AIDS Society Conference, to promote person first HIV & Sexual Health language.  

*Language matters. People living with or at risk of HIV experience stigma & discrimination and the wrong language perpetuates this.

===[https://www.shatterproof.org/sites/default/files/2021-02/Stigma-AddictionLanguageGuide-v3.pdf Shatter Proof - Addiction Language Guide]===

=Suggestions to add to this page=

===[https://www.ama-assn.org/system/files/ama-aamc-equity-guide.pdf  American Medical Association and the Association of American Medical Colleges (AAMC) Center for Health Justice]===

===[https://www.nih.gov/nih-style-guide/person-first-destigmatizing-language NIH Style Guide]===

===2021: [https://derma.jmir.org/2021/1/e28415 The Use of Person-Centered Language in Medical Research Journals Focusing on Psoriasis: Cross-sectional Analysis]===