Decreasing Smoking but Increasing Stigma? Anti-tobacco Campaigns, Public Health, and Cancer Care

“, the Health Belief Model [10], the theory of planned behavior [11, 12]) that focus broadly on cognitive, emotional, and social processes (e.”

“These types of ads are supported by well-established theories of health behavior change (e.g., the Health Belief Model [10], the theory of planned behavior [11, 12]) that focus broadly on cognitive, emotional, and social processes (e.g., perceived susceptibility to disease, health beliefs regarding the consequences of…”

“Some health scientists have labeled anti-tobacco public health campaigns “demoralizing” [22] and “victim blaming” [6].”

“And people who already feel disempowered tend to feel even more resentful, defensive, and demoralized after exposure to anti-tobacco campaigns [17, 36].”

“Emphasizing how much money is spent annually by the tobacco industry on tobacco advertising and social marketing has been a compelling theme for prior anti-tobacco campaigns, particularly those targeting prevention of youth smoking [37-39].”

“Finally, given that lung cancer stigma can intersect with social and structural hierarchies such as power, culture, and privilege [43], it would seem important for public health campaigns to target all tobacco users, not just ethnic minorities and tobacco users of low socioeconomic status [32].”

“Public health leaders assert that the hard-hitting ads are justified by the benefits observed in reducing smoking and related health consequences [5, 15-17].”

“There are several types of stigma that might be experienced by patients diagnosed with lung cancer: (1) anticipated stigma, or the expectation of discrimination, stereotyping, or prejudice; (2) enacted stigma, which involves actually experiencing discrimination, stereotyping, or prejudice; and (3) internalized stigma,…”

“The majority of persons diagnosed with lung cancer report experiencing stigma, often related to guilt, regret, perceived blame, and other negative beliefs about smoking history [16, 22-24].”

“Mental health clinicians caring for the psychosocial needs of cancer patients and health care ethicists have questioned whether the public health benefits are worth the “incidental” costs of stigma for individual patients [16, 34, 35].”

“Stigma is associated with a number of deleterious psychosocial and medical outcomes in lung cancer patients, including delayed diagnoses [25-27], poor quality of life [26], and poor patient-clinician communication [28].”

“Hard-hitting ads have been shown to be more effective than humorous or neutral educational communication messages at reducing smoking [13].”

“, the value of raising a family or maintaining health) might buffer against defensive processing—dismissal of a health message perceived as personally threatening—because it has been shown that selfaffirmation prior to exposure to graphic images on cigarette pack warnings reduces such defensive processing [41].”

“One study found that physicians miss 90 percent of opportunities for demonstrating empathy in lung cancer care [44].”

“Public health leaders assert that the hard-hitting ads are justified by the benefits observed in reducing smoking and related health consequences [5, 15-17].”

“One survey found that physicians were more likely to refer breast cancer patients than lung cancer patients for further therapy [29], which could be due to lung cancer stigma—the ubiquitous and damaging nature of which is well established [24, 28, 29].”

“Second, health care professionals treating patients with lung cancer can communicate empathically to build patients’ resilience and try to help inoculate them to the stigmatizing effects of anti-tobacco health campaigns [6, 24, 26, 28].”

“Public health leaders assert that the hard-hitting ads are justified by the benefits observed in reducing smoking and related health consequences [5, 15-17].”

“Emphasizing how much money is spent annually by the tobacco industry on tobacco advertising and social marketing has been a compelling theme for prior anti-tobacco campaigns, particularly those targeting prevention of youth smoking [37-39].”

“In its extreme form, stigma can be thought to “turn the individual into his own jailor, his own chorus of denunciation” [33].”

“Stigma is associated with a number of deleterious psychosocial and medical outcomes in lung cancer patients, including delayed diagnoses [25-27], poor quality of life [26], and poor patient-clinician communication [28].”

“Emphasizing how much money is spent annually by the tobacco industry on tobacco advertising and social marketing has been a compelling theme for prior anti-tobacco campaigns, particularly those targeting prevention of youth smoking [37-39].”

“64 million American smokers making a quit attempt; 100,000 of these smokers are expected to maintain smoking abstinence [8].”

“The majority of persons diagnosed with lung cancer report experiencing stigma, often related to guilt, regret, perceived blame, and other negative beliefs about smoking history [16, 22-24].”

“org 480 and problem-focused strategies may mitigate the negative consequences of stigma resulting from hard-hitting anti-tobacco campaigns [45].”

“Good patient-clinician communication has been associated with lower levels of stigma in the health care setting [28].”

“Hard-hitting media anti-smoking campaigns often focus on both raising awareness about the health consequences of smoking and denormalizing smoking behavior, thereby motivating prevention among the general public and motivating smokers specifically toward cessation [7-9].”

“Finally, given that lung cancer stigma can intersect with social and structural hierarchies such as power, culture, and privilege [43], it would seem important for public health campaigns to target all tobacco users, not just ethnic minorities and tobacco users of low socioeconomic status [32].”

“One survey found that physicians were more likely to refer breast cancer patients than lung cancer patients for further therapy [29], which could be due to lung cancer stigma—the ubiquitous and damaging nature of which is well established [24, 28, 29].”

“Hard-hitting media anti-smoking campaigns often focus on both raising awareness about the health consequences of smoking and denormalizing smoking behavior, thereby motivating prevention among the general public and motivating smokers specifically toward cessation [7-9].”

“The Joint United Nations Programme on HIV/AIDS (UNAIDS) has suggested that negative views of people living with HIV can be attributed largely to stigma and ignorance about the harm of stigma and moral judgment, which is likely germane to those suffering from tobaccorelated diseases [46].”

“Public health leaders assert that the hard-hitting ads are justified by the benefits observed in reducing smoking and related health consequences [5, 15-17].”

“, graphic warnings on cigarette packs) have been challenged by the tobacco industry [18, 19], the Family Smoking Prevention and Tobacco Control Act of 2009 gives the FDA authority to regulate the tobacco industry [20].”

“However, some evidence suggests that certain elements of smoking stigma may actually deter individual cessation efforts.(91)”

“Thus, researchers argue that an ethical burden exists to address the disproportionate experience of stigma among patients with lung cancer that is associated with negative sequelae, such as treatment deferral and increased distress.(11,12) A deeper examination of the stigma construct is required to understand the comp…”