Why Anti-Smoking Messages Have Potential To Backfire

By McCarton Ackerman 11/09/15

Some smokers don't like to be stigmatized.

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Public health policies targeted at smokers may not always help people quit. In fact, they may have the opposite effect, according to new evidence released this week.

The findings, published in Social Science & Medicine, suggest that policies like smoking bans may contribute to stigmatization of smoking, which can lead to defensiveness, stress and a drop in self-esteem among current or former smokers. These factors may actually drive people to resume smoking or smoke more.

"Consequences of stigmatizing stereotypes ranged from increased intentions to quit smoking to increased stress to greater resistance to quitting smoking," said study co-author Rebecca Evans-Polce, postdoctoral fellow, at Penn State.

After reviewing hundreds of articles about smoking and stigma, Evans-Polce and her colleagues from the U.K., Brazil and Germany noted that stigmatization of smoking may motivate some people to quit. But it can also have the reverse effect.

One study found that 30 to 40% of smokers felt high levels of disapproval from their family and society, and 27% felt people treated them differently because they smoked. Another study found that 39% of smokers believed that people thought less of them because of their habit. In multiple studies, smokers described themselves with negative terms like "leper," "outcast," "bad person," "low-life," and "pathetic."

These findings held true across different parts of the globe. "The stereotypes that smokers deal with are almost universally negative," said study co-author Sara Evans-Lacko, from the London School of Economics and Political Science. She added that the stigma is worse for parents who smoke. And in some parts of the world, it’s worse for women. For example, Pakistani and Bangladeshi women who smoked were viewed as "shameful" and "tainted" whereas male smokers from the same countries were considered "macho."

Though the results vary, stigmatization of smokers can contribute to relapses, resistance to quitting, increased stress and social isolation. The authors said that smokers, especially “vulnerable” populations with fewer coping resources, would benefit from anti-smoking programs that focus on the benefits of quitting but do not stigmatize the habit.

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.