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*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. | ||
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=='''Studies, Papers, Reports'''== | =='''Studies, Papers, Reports - Smoker'''== | ||
===2022: [https://www.sciencedirect.com/science/article/pii/S2772628222000103 Reducing stigma triggered by assessing smoking status among patients diagnosed with lung cancer: De-stigmatizing do and don't lessons learned from qualitative interviews]=== | ===2022: [https://www.sciencedirect.com/science/article/pii/S2772628222000103 Reducing stigma triggered by assessing smoking status among patients diagnosed with lung cancer: De-stigmatizing do and don't lessons learned from qualitative interviews]=== | ||
*Patients expressed clear preferences for CCPS to refrain from using judgmental labels when assessing smoking history, including a preference for questions such as ''' “have you smoked cigarettes in the past 30 days” rather than “are you a smoker?” '''. This perspective is consistent with the broader clinical efforts and dissemination of resources to reduce illness-related stigma through the increased use of person-first language and other bias-free language in clinical care and research | *Patients expressed clear preferences for CCPS to refrain from using judgmental labels when assessing smoking history, including a preference for questions such as ''' “have you smoked cigarettes in the past 30 days” rather than “are you a smoker?” '''. This perspective is consistent with the broader clinical efforts and dissemination of resources to reduce illness-related stigma through the increased use of person-first language and other bias-free language in clinical care and research. | ||
===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733058/ Changing the Language of How We Measure and Report Smoking Status: Implications for Reducing Stigma, Restoring Dignity, and Improving the Precision of Scientific Communication]=== | ===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733058/ Changing the Language of How We Measure and Report Smoking Status: Implications for Reducing Stigma, Restoring Dignity, and Improving the Precision of Scientific Communication]=== | ||
*However, the descriptors we commonly use to classify people who smoke may inadvertently perpetuate harmful, stigmatizing beliefs and negative stereotypes. In recognizing the power of words to either perpetuate or reduce stigma, Dr. Nora Volkow—Director of the National Institute on Drug Abuse—recently highlighted the role of stigma in addiction, and the movement encouraging the use of person-first language and eliminating the use of slang and idioms when describing addiction and the people whom it affects. | *However, the descriptors we commonly use to classify people who smoke may inadvertently perpetuate harmful, stigmatizing beliefs and negative stereotypes. In recognizing the power of words to either perpetuate or reduce stigma, Dr. Nora Volkow—Director of the National Institute on Drug Abuse—recently highlighted the role of stigma in addiction, and the movement encouraging the use of person-first language and eliminating the use of slang and idioms when describing addiction and the people whom it affects. | ||
*In this commentary, we make an appeal for researchers and clinicians to use person-first language '''(eg, “people who smoke”)''' rather than commonly used labels '''(eg, “smokers”)''' in written (eg, in scholarly reports) and verbal communication (eg, clinical case presentations) to promote greater respect and convey dignity for people who smoke. We assert that the use of precise and bias-free language to describe people who smoke has the potential to reduce smoking-related stigma and may enhance the precision of scientific communication. [emphasis added] | *In this commentary, we make an appeal for researchers and clinicians to use person-first language '''(eg, “people who smoke”)''' rather than commonly used labels '''(eg, “smokers”)''' in written (eg, in scholarly reports) and verbal communication (eg, clinical case presentations) to promote greater respect and convey dignity for people who smoke. We assert that the use of precise and bias-free language to describe people who smoke has the potential to reduce smoking-related stigma and may enhance the precision of scientific communication. [emphasis added] | ||
=='''Studies, Papers, Reports - Smoking'''== | |||
===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9086928/ What low-income smokers have learned from public health pedagogy: A narrative inquiry]=== | |||
*Frohlich et al and others have suggested that public health educational messages may have the unintended consequence of marginalizing low-income smokers and unintentionally contributing to health disparities. Our study participants also point to healthcare professionals as an important group who may be contributing to these feelings. With this in mind, efforts to educate healthcare providers on how their actions may be perceived as judgmental or lacking in compassion about the effects of nicotine withdrawal are warranted. | |||
===2020: [https://www.mdpi.com/1660-4601/17/12/4345/htm Stigma and Smoking in the Home: Parents’ Accounts of Using Nicotine Replacement Therapy to Protect Their Children from Second-Hand Smoke]=== | ===2020: [https://www.mdpi.com/1660-4601/17/12/4345/htm Stigma and Smoking in the Home: Parents’ Accounts of Using Nicotine Replacement Therapy to Protect Their Children from Second-Hand Smoke]=== | ||
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===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625812/ DOES IT HELP SMOKERS IF WE STIGMATIZE THEM? A TEST OF THE STIGMA-INDUCED IDENTITY THREAT MODEL AMONG U.S. AND DANISH SMOKERS]=== | ===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625812/ DOES IT HELP SMOKERS IF WE STIGMATIZE THEM? A TEST OF THE STIGMA-INDUCED IDENTITY THREAT MODEL AMONG U.S. AND DANISH SMOKERS]=== | ||
*Thus, stigmatization led smokers toward emotional, cognitive, and attitudinal reactions that might make them less likely to quit. | *Thus, stigmatization led smokers toward emotional, cognitive, and attitudinal reactions that might make them less likely to quit. | ||
===2008: [https://www.tandfonline.com/doi/abs/10.1080/09581590802687358 Tobacco control and the inequitable socio-economic distribution of smoking: smokers’ discourses and implications for tobacco control]=== | |||
*[https://sci-hub.se/10.1080/09581590802687358 Full Study on Sci-Hub] | |||
*Few low SES smokers questioned their smoking status, instead framing smoking as a ‘fact of life’. However, there was also a clear sense that tobacco control, and its adherents, are contributing to a sense of stigmatised identity for these smokers. | |||
=='''Studies, Papers, Reports - Employment and Insurance'''== | |||
===2018: [https://psycnet.apa.org/record/2017-40480-001 A qualitative review of tobacco research related to public and structural stigma.]=== | ===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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===2008: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006698/ Smoking and the emergence of a stigmatized social status]=== | ===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. | *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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