Smoking Stigma

Via NYC CLASH:

Why campaigns that stigmatize smokers can make them want to quit even less

…Yet, little is known about how those who smoke cope with smoking-related stigma that may stem from these strategies and the negative consequences of smoking-related stigma on those who smoke. Of particular concern are the potential consequences of internalizing public stigma which is referred to as self-stigma or internalized stigma as they are likely to vary for individuals. For example, the public stigma of smoking could result in four potential outcomes for smokers. The desired outcome and the one often assumed by public health practitioners is that smokers will internalize the stigma and quit smoking in order to feel better. However, there are at least three other potential outcomes which can be detrimental: (1) the smoker internalizes the smoking stigma, loses self-esteem and self-efficacy, and fails to quit smoking, (2) the smoker resists internalizing the smoking stigma remaining indifferent and fails to quit smoking, or (3) the smoker resists smoking stigma internalization, may become angry and defensive at the public for stigmatizing smoking, fails to quit smoking and may even increase their self-esteem and self-efficacy regarding smoking.

I’ve never internalised the smoking stigma, but I’ve encountered a few people who did. Most smokers I encounter seem to fall into category (2). They don’t think less of themselves for smoking, and remain indifferent to the stigma, and carry on smoking.

I suppose that of the four responses on offer, my own is nearest to (3).  I don’t internalise the stigma, and have lost no self-esteem. Instead I’ve got angry.

But not angry at “the public”. The general public don’t stigmatise smokers. In the 8 years since the introduction of the UK smoking ban, I’ve never once had anyone show the slightest sign of disapproval at seeing me smoking in a pub garden, or on the street, or in my car.

It’s not the public that’s doing the stigmatising. The people who are doing that are the people in Tobacco Control: the Deborah Arnotts and Linda Baulds and Ian Gilmores and Stanton Glantzes, who’ve somehow managed to get unrestricted access to the media to peddle their antismoking message. They’re the stigmatisers.

So the people I’m angry with are the people in Tobacco Control. And I’m not defensive about it. I’m on the attack. I’m always trying to think up ways of undermining and destroying them. Because that’s what I want to do. And I must have been a little bit effective because I’ve got my own page on the Tobaccotactics website. I’m not the only one who’s got their own page.

So really I should have a missing category (4), which would be something like:

(4) the smoker doesn’t want to quit smoking at all, is determined to carry on, resists smoking stigma internalisation, becomes very angry (“all-out F U anger” as Walt put it) at Tobacco Control for stigmatising smoking, goes on the attack with his blog, and plans to destroy the bastards.

The article is clearly written by a thoughtful antismoker (or is that an oxymoron?), because her ‘desired outcome’ is what I would regard as the ‘detrimental’ outcome. I think it’s detrimental to anybody to internalise a stigma that has been placed upon them. Stigmatising smokers is no different from stigmatising blacks, Jews, homosexuals, women, or anyone else. Even if the result of being stigmatised results in someone stopping smoking, it has been done by reducing their status, removing their dignity, and in a profound sense breaking them. The ex-smokers who have been made to stop smoking this way are broken people.

But I’m not at all sure that it’s the stigma placed on smoking that makes smokers stop smoking. Nor do I think that most smokers want to give up smoking. It’s one of the dogmas of Tobacco Control that “70% of smokers want to stop smoking”. But my impression is that 95% of them don’t want to stop smoking, or stop doing anything else they enjoy doing (drinking, eating). Why on earth should they want to stop doing something that they enjoy doing?

What happens instead, I think, is that insistent Smoking Kills messages gradually magnify smokers’ fears about disease and death, and these fears gradually come to outweigh the pleasure they take in smoking. And this is the point where their cost-benefit analysis tells them they should try to quit smoking. I think that pretty much all the smokers I’ve ever known gave up because they got worried about their health. They didn’t give up because they’d been stigmatised, because for the last 70+ years – apart from the last 10 years or so – there has been no stigma at all attached to smoking. Smokers give up smoking because they succumb to health fears promulgated by Tobacco Control, against which they have no defences. They have no defences against the massed ranks of doctors, authorities, experts, and the general consensus of opinion. They’re unable to swim against the tide.

I could say more, but that’ll do for now.

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About Frank Davis

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40 Responses to Smoking Stigma

  1. Smoking Lamp says:

    Nice analysis! I agree, the core of the stigma against smoking is tobacco control. They are masters of propaganda. Beyond that, they are relentless. They must be stopped.

  2. harleyrider1978 says:

    I suppose that of the four responses on offer, my own is nearest to (3). I don’t internalise the stigma, and have lost no self-esteem. Instead I’ve got angry.

    THATS ME………..8 YEARS ON STILL fighting the bloody bastards just like Frank.

  3. harleyrider1978 says:

    OT

  4. Tony says:

    It seems to me that category 4 is comprised of people who previously believed at least some of the propaganda but have finally been motivated to research the subject. At which point they’ve discovered that they have been lied to for years. Some seem to stop researching once they’ve uncovered the passive smoking lie but others go further and get to both the root of the fraud and the vile ideology that underpins it.

    I respectfully suggest that both you and most of your readers fall into this category. I certainly do. There’s probably a further category that consists of people who’ve known all along.

    • Frank Davis says:

      Yes, you’re right. Part of my journey has entailed going and reading the original research – e.g. the 1950 London Hospitals study – and realising just how bad it was.

      But I think there’s a psychological barrier here that some people just can’t get over. They can’t stop believing that Smoking Kills or Smoking Causes Lung Cancer. I had difficulty myself. Because it’s almost like stopping believing that the Earth goes round the Sun, the conditioning is so strong.

      There’s probably a further category that consists of people who’ve known all along.

      Undoubtedly.

      • Rose says:

        I never could get past the question in my young mind, as the tobacco plant contains the same plant chemicals that are found in nightshade vegetables just in larger amounts, if lung cancer is blamed on tobacco why aren’t potatoes and tomatoes blamed for causing bowel cancer, after all they are consumed in greater amounts and stay in the body much longer. But not so much as a squeak in condemnation of them.

        I was born in the days of the industrial smogs and was in no doubt as to what was really causing respiratory diseases.
        Mind you, I didn’t fall for the saturated fat theory either.

        I may be one of the very few to take up smoking solely because I wanted to know what anti-tobacco was hiding, I knew that there was nothing exotic in tobacco and couldn’t really see the point..

        Now it seems that they didn’t know either.

      • harleyrider1978 says:

        Its not so hard to believe smoking doesn’t cause what they claim when after 100 years they still cant prove one single disease entity.

        JOINT STATEMENT ON THE RE-ASSESSMENT OF THE TOXICOLOGICAL TESTING OF TOBACCO PRODUCTS”
        7 October, the COT meeting on 26 October and the COC meeting on 18
        November 2004.

        “5. The Committees commented that tobacco smoke was a highly complex chemical mixture and that the causative agents for smoke induced diseases (such as cardiovascular disease, cancer, effects on reproduction and on offspring) was unknown. The mechanisms by which tobacco induced adverse effects were not established. The best information related to tobacco smoke – induced lung cancer, but even in this instance a detailed mechanism was not available. The Committees therefore agreed that on the basis of current knowledge it would be very difficult to identify a toxicological testing strategy or a biomonitoring approach for use in volunteer studies with smokers where the end-points determined or biomarkers measured were predictive of the overall burden of tobacco-induced adverse disease.”

        In other words … our first hand smoke theory is so lame we can’t even design a bogus lab experiment to prove it. In fact … we don’t even know how tobacco does all of the magical things we claim it does.

        The greatest threat to the second hand theory is the weakness of the first hand theory.

  5. Lepercolonist says:

    I know ex-smokers who have bummed a cigarette and when confronted about their abstinence they state that they can no longer afford cigarettes but would love one now. You are correct Frank, they have been broken in many ways.

    • Frank Davis says:

      That doesn’t surprise me. If someone once enjoyed smoking, and unwillingly quit, they’ll probably rather envy those smokers who carry on smoking, and occasionally bum a cigarette off them.

      I think there are probably lots of ex-smokers who’d dearly love to start smoking again, but are too terrified to do so. I’ve read of ex-smokers who dream of cigarettes every night.

      • harleyrider1978 says:

        From my readings the newest smokers are former smokers who started back up again. Average restart time was 6 months after cessation.

      • Jude says:

        I think one of the saddest things I have seen recently, are friends that were smokers, and bought the lie, gave up smoking when they had kids. They were visiting at xmas, with said kids, and would bum smokes off others, and then proceed to hide from said children to smoke them. They were afraid of their own children, because of the brainwashing their kids received in primary school about smoking. Sad and sickening.

        • jaxthefirst says:

          One of the strangest “smoking non-smokers” I ever heard of was the husband of a friend of mine. He was something of a rabid anti-smoker – whenever any of her smoker friends came to visit they had to go out to the garden to smoke. She then revealed to us that shortly after they were married it turned out that he was a cross-dresser with a whole alter-ego who manifested herself only when s/he was dressed as a female – and this female character was a total chain-smoker! She told me all this some time after they had divorced (nothing to do with the cross-dressing, by the way – he had an affair), and I couldn’t help wishing that the alter-ego had been around whenever I’d visited (she never was), because she sounded like better company, and I suspect I would have liked her a lot more than I liked him!

  6. Zaphod says:

    I think there may be a unrecognised significant minority or early quitters, those who never really enjoyed smoking but just joined in to be part of what was then the majority. (There are people like that, you know.)
    The ease of getting them to quit, gave the impression that enough pressure would get us all to quit?

    Not a major point, but worth acknowledging in a thorough analysis?

    • Frank Davis says:

      those who never really enjoyed smoking but just joined in to be part of what was then the majority. (There are people like that, you know.)

      I do indeed know. My mother was one of them. She only used to smoke on social occasions like parties or dances. When I eventually asked her about it, she said she did it “to join in”. There was no other reason. She was puzzled why people smoked. And asked me why I did.

      There are undoubtedly lots of people like this. For example, they may not enjoy swimming or sunbathing or sitting half-naked on sand, but they’ll “join in” a day trip to a beach. But if sufficient numbers of people say they no longer want to go to beaches, they’ll ‘join in’ on their side – because they never really wanted to go and get their hair filled with sand and seawater.

      • Rose says:

        I was like that with alcoholic drinks, but in those days the only other option in a pub was Britvic Orange or some unspeakable stuff that passed itself off as lemonade.
        They’d only just started serving coffee when I was banned from every pub, club, bar, cafe and hotel in England.

  7. Igrowmyown says:

    Many perceptive comments so far,my journey through these decades of incessant propaganda has been skepticism of the propaganda until the late 90s when I too began to absorb the ‘deadly’ health message which culminated in attempting to quit before the smoking ban in 2007, however this proved futile whilst my wife and I were looking after my mother with dementia of an aggressive type.This was when I began reading up on pro- smoking websites and discovering an alternative truth to the propaganda peddled by vicious anti-smokers,so thank you all you people who have had the anger and the courage to resist these fucking bastards.

    • harleyrider1978 says:

      Id be the first to say TY

    • Frank Davis says:

      this proved futile whilst my wife and I were looking after my mother with dementia of an aggressive type.

      I can entirely understand that. I looked after my slightly-demented mother for some years, and I know how stressful it can be. But if it all got too much, I could climb in my car and head down to our local pub, and regain my composure with a pint and a few cigarettes. Fortunately, that was before the UK smoking ban was introduced, and I could still do that. It would be quite impossible now.

      I think stressful situations like this are very often accompanied by the urge to smoke a soothing, calming cigarette. My landlady of many years used to frequently come knocking at my door to cadge a roll-up off me, after one or other stressful event in her life. She’d sit patiently waiting for me to roll one, while saying “I really shouldn’t” and “I know it’s bad for you”. She eventually became a full antismoker. I often wonder what she does now when she gets stressed. I wouldn’t be surprised if she now keeps a secret stash of cigarettes somewhere.

      The most obvious stressful situation is wartime. It doesn’t surprise me at all that many (most?) servicemen are smokers.

      Equally, one could say that hospitals are stressful environments. No surprise that patients (and visitors!) will gather outside to smoke.

      Many work environments are pretty stressful as well.

      • Rose says:

        The most obvious stressful situation is wartime

        I’ve always been intrigued by the practice of giving a cigarette to a wounded soldier and know I think I know why.

        It seems that we carry an on demand, non-prescription, natural antidepressant everywhere we go.

        “Specifically, long-term smoking appears to inhibit monoamine oxidase (or acts as an MAO inhibitor). Monoamine oxidase is the enzyme that metabolizes monoamines — such as norepinephrine, dopamine and serotonin, Klimek explained. The locus coeruleus produces norepinephrine. Drugs that inhibit monoamines are antidepressants.”

        “They ground up tobacco leaves and tested representative samples in a test tube to see if they inhibited MAO. From the fraction containing the most potent MAO inhibitor, they isolated a chemical known as 2,3,6-trimethyl-1,4-naphthoquinone.”

        https://cfrankdavis.wordpress.com/2015/02/12/342-credulous-idiots/#comment-112456

        That rings so many bells.

        (2) the smoker resists internalizing the smoking stigma remaining indifferent and fails to quit smoking,

        or

        (3) the smoker resists smoking stigma internalization, may become angry and defensive at the public for stigmatizing smoking, fails to quit smoking and may even increase their self-esteem and self-efficacy regarding smoking.

        Now add the antidepressant effect to the mix and see what’s really happening.

        In my view “the smoker” doesn’t resist “internalizing the smoking stigma” and doesnt remain “indifferent”, they just light up another cigarette and deal with it.

        • harleyrider1978 says:

          Back in 1980 as a lowly e-4 an old lady at the base exchange told me they were after tobacco prohibition again. She had seen it before and was the first to warn me about it.

          After that I endured 3 of then SG KOOPS sermons at NAS jax hospital on smoking.
          We laughed doctors surgeons etc etc…………
          But I had told that woman if they ever tried that Id fight them to the bitter end,I assume Ive kept my pledge.

  8. Timothy Goodacre says:

    A very good analysis as usual Frank. These anti amoking zealots just can’t face the fact that most smokers enjoy smoking and don’t want to give up. Another point is that apart from the costs they have imposed on smokers is the fact that in May 2016 those of us who enjoy Turkish.Oriental, Black Russian etc will no longer be able to enjoy our cigarette of choice due either to flavoured cigs being banned, coloured cig paper being banned, or the high cost of producing special medical porn packets for small volumes pricing them off the market.
    This makes me very cross.

  9. Frank Davis says:

    Strange:

    But one story I tell in this book is that this surgeon general, who’s a gentleman called Luther Terry, was chain smoking on his way to the press conference where he was going to introduce the surgeon general’s report. His aide was sitting next to him in the car and said “Dr Terry, I should prepare you for this, you’re not going to like it but the first question you will be asked is ‘do you smoke’?” and Luther Terry says “that’s ridiculous! That’s a private question, that’s nothing to do with public health”, you know, how dare they? And the aide said “Well, you know, I’m just telling you” and the first question was “Do you smoke” and Luther Terry said “No, I do not smoke” and they said “When did you quit?” and he said “20 minutes ago!”

    He continued:

    Turning that story on it’s head; here’s the surgeon general, he’s a physician and quit within 20 minutes of his own report. Most physicians quit pretty quickly after that too. Most educated people followed. Most wealthy people followed. So then what you had was the people left behind. Now you don’t think that’s bad because you know, OK a lot of people did better, no one’s worse off that they were before, why is the world a worse place? But 50 years later when those inequalities are still there does that seem such a good thing? There’s some structural inequality there which is very – seems very hard to erase and it seems morally very ambiguous. So that’s one sort of inequality that seems really problematic. There are many others.

    I see. When they’re talking about “health inequalities”, they don’t mean that some people are in worse health than others, but that some people are leading “unhealthier” lives than others (e.g. by continuing to smoke). Their actual health status (well or unwell) is unimportant.

    • magnetic01 says:

      Most physicians………. Most educated people followed. Most wealthy people followed.

      Another economist that’s jumped on the “healthist” bandwagon. It’s a shame that he’s history illiterate (and science illiterate, and human nature illiterate).

      If he knew anything of early last century, he would recognize the pattern. Eugenics (that included anti-tobacco/alcohol) was physician-led. Most educated people followed. Most wealthy people followed. There were very few critics of eugenics at the time as is the case now with neo-eugenics – “healthism” (hygienism).

      So then what you had was the people left behind.

      So what we have left – those not following the physician lead….those continuing to smoke – are the poor/uneducated. The “intelligent” have abandoned smoking. So, only the “unintelligent” continue smoking. To repair this “inequality”, smokers are “helped”, coerced through a variety of State applied punishments, to become one of the “intelligent” (or at least following the lead of the “intelligent”) by quitting smoking. Those that persist in “unintelligent” behaviour – smoking – must be separated from the approved population, deemed deviant, anti-social. There would be no such hope of “redemption” if the issue was purely racial.

      The prohibitionism involved – to get (force) smokers to quit and no-one else to start smoking, with its root in the medicalization of humanity, is a eugenics program that affirms/reinforces the superiority of the medical establishment/model, the upper-class, and the upper-class wannabe – the bourgeoisie.

      The eugenics of early last century should be a reminder that physicians, the “educated”, and the wealthy can get it terribly, terribly wrong; they are prone to serious, destructive derangement inflicted on society as “benevolent” social engineering and where it’s those of low social status that bear the brunt. It’s a critical lesson that’s been completely lost.

      The promise of longevity – the only dimension that eugenics has to play with given that it’s devoid of most of the dimensions that make humans human – is most appealing to the shallow wealthy. The [materially] wealthy want to hang on to the wealth and the social power/influence it entails for as long as possible. If I remember correctly, someone in the film Loser Takes All (1956) reasonably comments, “People are so afraid of growing old when they’re rich”.

      For anyone interested, I posted a series of comments on eugenics here:
      https://cfrankdavis.wordpress.com/2011/06/23/the-nazi-antismoking-legacy-1/

      • Frank Davis says:

        The social control/ social engineering agenda is quite overt in the article I posted above:

        “These types of social control strategies, which are employed in an effort to reduce the prevalence and incidence of smoking and reduce exposure of non-smokers to second-hand and third-hand smoking may actually further marginalize ‘residual smokers’ who may be more disadvantaged and have fewer resources to help them quit.”

  10. Cecily Collingridge says:

    Frank wrote: “The general public don’t stigmatise smokers. In the 8 years since the introduction of the UK smoking ban, I’ve never once had anyone show the slightest sign of disapproval at seeing me smoking in a pub garden, or on the street, or in my car.” Judging by the comments so far, this experience seems to be shared.

    However, this is not my experience. I have had complete strangers come up to me to tell me I should stop smoking and some have been aggressive. The first occasion was about 3 or 4 years ago. I was in my little local park on a lovely sunny day where I had gone to listen to an open air concert given by local musicians. Perhaps, as a lone, thin grey-haired lady who was seated on this and all subsequent occasions, I appear an easy target who won’t come after them.

    I classify this behaviour as hate crime.

    • Frank Davis says:

      Perhaps, as a lone, thin grey-haired lady … I appear an easy target

      I think that’s the most likely explanation. After all, there are quite a few antismokers out there, who’ll be wanting to call out smokers. And what’s easier than an old lady? They probably wouldn’t dare with any man.

      That said, they would like to get the general public to do their policing for them. They always try to get other people to do their work for them. Deborah Arnott would never do any policing herself: she gets other people to do it. That’s how Tobacco Control always works.

  11. Nell says:

    Hate crime is right! Which other group in our society would tolerate this kind of discrimination?

    Soooo sick of do gooders, paid by our taxes, inflating ‘health risks’ to keep themselves in employment, or zealots spouting cr@p because they want everyone else to lead their boring sanitised lives.
    They are using the same tactics for sugar, ecigs and alcohol. ‘Lets reduce the safe limits, then the problem will seem greater, we’ll keep our tax funded jobs.’
    I kept smoking more cigarettes than I really wanted, because I got angry and wanted to say ‘up yours’ to the lot of them.
    The fact I switched to vaping (tried it one winter, to see if I could avoid my yearly cold/down onto chest/dreadful cough) and never switched back, is simply my choice, everyone should choose what they enjoy.

    The number of times I explain about the results of the smoking/secondhand smoke trials and how they were manipulated and the outright lies circulated, I’m always amazed at the complete disbelief this generates. My final response is usually – well, you’ve been warned, look for yourself if you don’t believe me and make no mistake, the same tactics will be coming to something you love to do – and soon!

    Rant over!

  12. harleyrider1978 says:

  13. harleyrider1978 says:

  14. Cecily Collingridge says:

    The other crime is the denial among health professionals that stigma detrimentally impacts patients with respiratory diseases who are given no support in dealing with it. It was not even mentioned on the poor pulmonary rehabilitation programme I attended. I complained about it in my feedback to the course provider and to my local Clinical Commissioning Group (among other things). One example of the internalisation of stigma is where patients accept being automatically branded smokers in hospitals even when they haven’t smoked in their lives or gave up years ago and are not believed. Stigma also contributes to depression and poorer levels of support from family and friends.

    • harleyrider1978 says:

      Hell they don’t tell you nothing not even the adverse side effects of the drugs they demand you take when leaving the hospital. They don’t even bother to tell you to watch out for PTSD after leaving an ICU ward……..they don’t do shit except sell fear! and pharma drugs that kill.

  15. Pingback: Self-Induced Social Isolation and Self-Stigma | Frank Davis

  16. Pat Nurse says:

    Last year I had to attend a seminar. In the break, I nipped out to smoke and there was just me and a very nice vaper and we had a nice chat. The next time I ventured out in the break, there was a women not smoking, nor vaping, sat next to the vaper. I said hello and sat down and started to roll a cig and chat. The woman asked :”Are you going to smoke that?” I said yes of course. She said to her vaper friend that, in that case, she would leave us to it, got up and left. Stigma.

    Deliberate stigmatisation is denormalisation by it’s plain english name which was designed to ensure smoker stigmatisation and to encourage social extremism in people like the intolerant smokerphobic friend of the vaper above. That aimed to force us to quit via social exclusion which is why we were stigmatised deliberately.

    It never affected me when it was a covert underground concept but once it came out loud and vile, it only made me angry and more determined to lay claim over my own decisions, my own body, my own life and my own choices.

    Anyways, I left a comment at the smokerphobic’s blog along the following lines. (I think, we have to start addressing these people as they are and expose them for what they are. Bigots and control freaks.)

    Remember the ads : “If YOU smoke YOU stink” and the myriad of abusive TV campaigns that ran over a decade as Labour prepared for the blanket smoking ban of 2007. There is even nasty and abusive posters about the “smelly, dirty, skint, disgusting, selfish, pathetic addict smoker” in schools. Also campaigns which suggest that we are employment liabilities, awful tenants, terrible friends, child abusing parents, etc… That is not stigma we have brought down on ourselves. That has been forced upon us. When they say to me : “but you can go in a pub. You just can’t smoke. What’s wrong with that?” I say how can I support a law that I fought against, that I profoundly disagree with, and to go in a pub as I used to, or a cafe to sit and write, or a restaurant for its ambience and atmosphere, which simply isn’t the same without smoke, is to say I surrender and accept this law. That is never going to happen. Bad laws must be ignored. But they should not blame me as a smoker for being stigmatised. They should instead blame the thugs in industry and public health who funded what has become a hate campaign. If we’re not stigmatised, then let us have our own meeting places indoors. Until that happens the blame for stigmatising smokers lies with quangos, corporate charities, civil servants, politically motivated junk scientists and smokerphobic politicians in both local and national Govt.

    Incidentally, harm reduction is more than just quitting smoking and going on ecigs or smokeless. It’s also about smoking less and, actually, having the same rights as non smokers in fair tax because high tax leads to a black market, and an unregulated or even contaminated product. All of that I am sure is welcomed by smokerphobics as a means to kill off smokers quicker.

    They are the ones who should feel stigmatised and the ones who should be socially excluded, banned from jobs and housing, while suffering all of the indignities that they have heaped on us.

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