Once upon a time smoking used to be considered cool. But over the last few decades, the status of smoking has gone from trendy to practically pariah. Smokers who used to be cool are now shunned.
Public Health Campaigns
There have been many public health campaigns that stigmatize smoking. This has led to smokers becoming angry and defensive, which in turn leads them to refuse quitting. Other smokers tend to feel bad and in turn give up their attempts to quit. This has been an unintended consequence, although not a wholly unexpected one, since the same is true for other mental health conditions.
Degree of Stigmas
What has been unexpected however, is the degree of stigma attached to smoking, and how much the smokers themselves identified with the stereotypes. Smokers have expressed feelings of shame and embarrassment, even guilt, and described themselves as outcasts, pathetic, low life, bad person and worse. These feelings intensified when their attempts to quit smoking were unsuccessful.
While it is true that some smokers said that the stigma associated with smoking strengthened their intentions to quit, many others felt low self esteem and hopeless. The ones who became defensive started feeling angry at the government and public health advocates for the extent smoking was being stigmatized, and continued smoking as a defiant method of shielding their self esteem.
Shaming Doesn’t Work
There are and have always been negative consequences when certain groups are stigmatized. This is simple behavioral psychology. Shaming smokers does not motivate them to quit. Perhaps some but definitely not all. But it does bring on negative feelings of shame, self loathing and other negative emotions.
That being said, the public health campaign against smoking has been quite successful. Only 17.8% of Americans are smokers today. Fifty years ago that number was as high as 42%. This decline in smoking has come about due to various efforts and programs, including cigarette taxation, smoke free air laws, media campaigns on the dangers of smoking, even smoking being deglamorized in the movies.
There is no doubt that this is a good thing, and has decreased not only the prevalence of smoking but also exposure of non smokers to second hand smoke. However, it has marginalized those who have continued to smoke. Progress has been made in preventing younger generations from starting the smoking habit, but according to the American Cancer Society only 4% to 7% of existing smokers are able to quit without medication, patches or some other form of assistance.
So, What’s Needed?
The time to get serious of reframing the anti smoking message is now. Along with the existing intervention strategies, there need to be an increased focus on positive reinforcement. Rather than the traditional approaches to quit smoking, which puts the spotlight on willpower and controlling the urge to smoke, it is important to pinpoint an approach which increases the smoker’s willingness to accept that there are challenges, physical, mental and emotional, to quitting. Such an approach encourages the smoker’s commitment to make a behavioral change.
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