Hostname: page-component-5d59c44645-hb754 Total loading time: 0 Render date: 2024-02-26T13:53:31.163Z Has data issue: false hasContentIssue false

Smoking, Stigma and Social Class

Published online by Cambridge University Press:  15 June 2011

Seebohm Rowntree Building, Department of Health Sciences, University of York, York YO10 5DD email:


The decline in cigarette smoking in high-income countries is attributed to the increasing social unacceptability of smoking, a cultural shift in which tobacco control policies are identified as playing a major part. While seen as essential to protect public health, there is a growing appreciation that these polices may have contributed to a social climate in which smoking is stigmatised. The paper reviews this debate on smoking and stigma. It notes that individuals are represented by their smoking status; other social differences are typically treated as secondary. Thus, while the links between disadvantage and smoking are acknowledged, social class remains on the margins of the debate. The paper argues instead that class provides an essential analytic lens through which to understand the stigma of smoking and the stigmatising impacts of tobacco control policies. In support of its argument, it discusses how the stigmatisation of smoking has occurred against a backdrop of widening socioeconomic differentials in smoking and the increasing importance of the body and behaviour in public discourses about social class and moral worth. The paper concludes by underlining the importance of embedding tobacco control research and policy in an appreciation of social class, and social inequalities more broadly.

Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Aaranovitch, D. (2000), ‘Why I am so afraid of Paulsgrove woman’, The Independent, 11 August 2000.Google Scholar
Alamar, B. and Glantz, S. (2006), ‘Effect of increased social unacceptability of cigarette smoking on reduction in cigarette consumption’, American Journal of Public Health, 96: 8, 1359–63.Google Scholar
Bayer, R. (2008), ‘Stigma and the ethics of public health: not can we but should we’, Social Science and Medicine, 67: 3, 463–72.Google Scholar
Bayer, R. and Stuber, J. (2006), ‘Tobacco control, stigma, and public health: rethinking the relations’, American Journal of Public Health, 96: 1, 4750.Google Scholar
Berridge, V. (1998), ‘Science and policy: the case of postwar British smoking policy’, in Lock, S., Reynolds, L. and Tansey, E. M. (eds.), Ashes to Ashes: The History of Smoking and Health, Amsterdam: Editions Rodopi BV.Google Scholar
Berridge, V. and Loughlin, K. (2005), ‘Smoking and the new health education in Britain 1950s–1970s’, American Journal of Public Health, 95: 6, 956–64.Google Scholar
Brandt, A. (1990), ‘The cigarette, risk, and American culture’, Daedalus, 119: 4, 155–76.Google Scholar
Brandt, A. (1997), ‘Behavior, disease, and health in the twentieth-century’, in Brandt, A. M. and Rozin, P. (eds.), Morality and Health, London: Routledge.Google Scholar
Brandt, A. (1998), ‘Blow some my way: passive smoking, risk and American culture’, in Reynolds, L. and Tansey, E. M. (eds.), Ashes to Ashes: The History of Smoking and Health, Amsterdam: Editions Rodopi.Google Scholar
Brandt, A. (2007), The Cigarette Century, New York: Basic Books.Google Scholar
Breen, R. and Rottman, D. B. (1994), Class Stratification: A Comparative Perspective, Hemel Hempstead: Harvester Wheatsheaf.Google Scholar
Burgess, D., Fu, S. and van Ryn, M. (2009), ‘Potential unintended consequences of tobacco-control policies on mothers who smoke: a review of the literature’, American Journal of Preventative Medicine, 37: 2, S151S158.Google Scholar
Burris, S. (2008), ‘Stigma, ethics and policy: a commentary on Bayer's “Stigma and the ethics of public health: not can we but should we”’, Social Science and Medicine, 67: 473–5.Google Scholar
Calder, A. and Sheridan, D. (eds.) (1984), Speak for Yourself: A Mass-Observation Anthology, 1937–49, London: Jonathan Cape.Google Scholar
Center for Disease Control and Prevention (CDC) (2010), Smoking Prevalence among US Adults, 1955–2007, from [last accessed 21 August 2010].Google Scholar
Chapman, S. (1993), ‘Unravelling gossamer with boxing gloves: problems in explaining the decline in smoking’, British Medical Journal, 307: 429–32.Google Scholar
Chapman, S. and Freeman, B. (2008), ‘Markers of the denormalisation of smoking and the tobacco industry’, Tobacco Control, 17: 1, 2531.Google Scholar
Charlesworth, S. (2000), A Phenomenology of Working Class Experience, Cambridge: Cambridge University Press.Google Scholar
Coxhead, L. and Rhodes, T. (2006), ‘Accounting for risk and responsibility associated with smoking among mothers of children with respiratory illness’, Sociology of Health and Illness, 28: 1, 98121.Google Scholar
Craig, R., Mindell, J. and Hirani, V. (2009), Health Survey for England 2008, London: The Information CentreGoogle Scholar
Davidson, G. (2004), ‘Sites to check out if you chav what it takes’, Edinburgh Evening News, 4 February 2004.Google Scholar
Department of Health (DH) (2011), Healthy Lives, Healthy People: A Tobacco Control Plan for England, London: Department of Health.Google Scholar
Doll, R. and Bradford Hill, A. (1950), ‘Smoking and carcinoma of the lung: preliminary report’, British Medical Journal, 2: 739–48.Google Scholar
Farrimond, H. and Joffe, H. (2006), ‘Pollution, peril and poverty: a British study of the stigmatization of smokers’, Journal of Community and Applied Social Psychology, 16: 6, 481–91.Google Scholar
Feldman, E. and Bayer, R. (eds.) (2004), Unfiltered: Conflicts over Tobacco Policy and Public Health, Cambridge, MA: Harvard University Press.Google Scholar
Finch, L. (1993), The Classing Gaze: Sexuality, Class and Surveillance, St Leonards, NSW, Australia: Allen & Unwin.Google Scholar
Forey, B., Hamling, J., Lee, P. and Wald, N. (2002), International Smoking Statistics (2nd edn), Oxford: Oxford University Press.Google Scholar
Goffman, E. (1963), Stigma: Notes on the Management of Spoiled Identity, Harmondsworth, Middlesex: Penguin.Google Scholar
Goldstein, J. (1991), ‘The stigmatization of smokers: an empirical investigation’, Journal of Drug Education, 21: 2, 167–82.Google Scholar
Graham, H. (2009a), ‘Women and smoking’, Drug and Alcohol Dependence, 104S: S11S16.Google Scholar
Graham, H. (2009b), ‘Tackling health inequalities: the scope for policy’, in Graham, H. (ed.), Understanding Health Inequalities, Buckingham: Open University Press.Google Scholar
Graham, H., Hawkins, S. and Law, C. (2010), ‘Lifecourse influences on women's smoking before, during and after pregnancy’, Social Science and Medicine, 70, 582–87.Google Scholar
Graham, H., Inskip, H., Francis, B. and Harman, J. (2006), ‘Pathways of disadvantage and smoking careers: evidence and policy implications’, Journal of Epidemiology and Community Health, 60: supplement 2, ii7ii12.Google Scholar
Graham, H. and McDermott, E. (2006), ‘Qualitative research and the evidence base of policy: insights from studies of teenage mothers in the UK’, Journal of Social Policy, 35: 1, 2137.Google Scholar
Hammond, D., Fong, G., Zanna, M., Thrasher, J. and Borland, R. (2006), ‘Tobacco denormalization and industry beliefs among smokers from four countries’, American Journal of Preventive Medicine, 31: 3, 225–32.Google Scholar
Harris-Roxas, B. F., Harris, P. J., Harris, E. and Kemp, L. A. (2011), ‘A rapid equity focused health impact assessment of a policy implementation plan’, International Journal for Equity in Health, 10: 6 [last accessed 30 January 2011].Google Scholar
Hayward, K. and Yar, M. (2006), ‘The “chav” phenomenon: consumption, media and the construction of a new underclass’, Crime, Media, Culture, 2: 1, 928.Google Scholar
Helasoja, V., Lahelma, E., Prattala, R., Patja, K., Klumbiene, J., Pudule, I. and Kasmel, A. (2006), ‘Determinants of daily smoking in Estonia, Latvia, Lithuania, and Finland in 1994–2002’, Scandinavian Journal of Public Health, 34: 4, 353–62.Google Scholar
Hilton, M. (2000), Smoking in British Popular Culture, Manchester: Manchester University Press.Google Scholar
Huisman, M., Kunst, A. and Mackenbach, J. (2005), ‘Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries’, Tobacco Control, 14: 2, 106–13.Google Scholar
Joosens, L. and Raw, M. (2006), ‘The tobacco control scale: a new scale to measure country activity’, Tobacco Control, 15: 247–53.Google Scholar
Kelly, M. (2010), ‘Regulating the reproduction and mothering of poor women’, Journal of Poverty, 14: 7696.Google Scholar
Kim, S.-H. and Shanahan, J. (2003), ‘Stigmatising smokers: public sentiment toward cigarette smoking and its relationship to smoking behaviours’, Journal of Health Communication, 8: 343–67.Google Scholar
Lader, D. (2009), Smoking-related Behaviour and Attitudes, 2008/09, London: Office for National Statistics.Google Scholar
Lawler, S. (2005), ‘Disgusted subjects: the making of middle-class identities’, Sociological Review, 53: 3, 429–46.Google Scholar
Letherby, G., Wilson, C., Bailey, N. and Brown, G. (2001), Supported Semi-independent Housing for under 18 Lone Parents, Coventry: Coventry Health Authority and Centre for Social Justice, Coventry University.Google Scholar
Link, B. and Phelan, J. (2009), ‘The social shaping of health and smoking’, Drug and Alcohol Dependence, 104: supplement 1, S6S10.Google Scholar
Link, B. G. and Phelan, J. (2001), ‘Conceptualising stigma’, Annual Review of Sociology, 27: 528–9.Google Scholar
Lopez, A., Collishaw, N. and Piha, T. (1994), ‘A descriptive model of the cigarette epidemic in developed countries’, Tobacco Control, 3: 242–7.Google Scholar
Lopez, A., Mathers, C. D., Ezzati, M., Jamison, D. T. and Murray, C. J. L. (2006), Global Burden of Disease and Risk Factors, Oxford: Oxford University Press and World Bank.Google Scholar
Louka, P., Maguire, M., Evans, P. and Worrell, M. (2006), ‘“I think that it's a pain in the ass that I have to stand outside in the cold and have a cigarette”: representations of smoking and experiences of disapproval in UK and Greek smokers’, Journal of Health Psychology, 11: 3, 441–51.Google Scholar
Marsh, A. and Matheson, J. (1983), Smoking Attitudes and Behaviour, London: Office of Population Censuses and Surveys.Google Scholar
McKennell, A. and Thomas, R. (1967), Adults’ and Adolescents’ Smoking Habits and Attitudes, London: HMSO.Google Scholar
Mishel, L., Bernstein, J. and Allegretto, S. (2007), The State of Working America, 2006–07, Ithica, NY: ILR Press.Google Scholar
Morbidity and Mortality Weekly Report (MMWR) (1988), ‘Passive smoking: beliefs, attitudes, and exposures – United States, 1986’, Journal of the American Medical Association, 259: 19, 2821–5.Google Scholar
Müller, W. and Gangl, M. (eds.) (2003), Transitions from Education to Work in Europe, Oxford: Oxford University Press.Google Scholar
Office for National Statistics (ONS) (2001), Living in Britain: Results from the 2000 General Household Survey, London: Office for National Statistics.Google Scholar
Parker, R. and Aggleton, P. (2003), ‘HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action’, Social Science and Medicine, 57: 1324.Google Scholar
Petersen, A. and Lupton, D. (1996), The New Public Health: Health and Self in the Age of Risk, London: Sage.Google Scholar
Philip Morris International (1984), Interoffice correspondence, 7 April, [last accessed 4 September 2010].Google Scholar
Platt, S., Amos, A., Godfrey, C., Martin, C., Ritchie, D. and White, M. (2009), Evaluation of Smokefree England: A Longitudinal Qualitative Study, [last accessed 4 September 2010].Google Scholar
Pleis, J. and Lethbridge-Çejku, M. (2007), Summary Health Statistics for US Adults: National Health Interview Survey, 2006, Washington, DC: National Center for Health Statistics.Google Scholar
Poland, B., Frohlich, K., Haines, R. J., Mykhaloyskiy, E., Rock, M. and Sparks, R. (2006), ‘The social context of smoking: the next frontier in tobacco control’, Tobacco Control, 15: 5963.Google Scholar
Ritchie, D., Amos, A. and Martin, C. (2010), ‘“But it just has that sort of feel about it, a leper”: stigma, smoke-free legislation and public health’, Nicotine and Tobacco Research, 12: 6, 622–9.Google Scholar
Royal College of Phsyicians (RCP), (1962), Smoking and Health, London: Pitman Medical Publishing Company.Google Scholar
Savage, M. (2000), Class Analysis and Social Transformation, Buckingham: Open University Press.Google Scholar
Seccombe, K., James, D. and Walters, K. (1998), ‘“They think you ain't much of nothing”: the social construction of the welfare mother’, Journal of Marriage and the Family, 60: 4, 849–65.Google Scholar
Skeggs, B. (1997), Formations of Class and Gender, London: Sage.Google Scholar
Singh, S., Darroch, J. and Frost, J. and the Study Team. (2001), ‘Socioeconomic disadvantage and adolescent women's sexual and reproductive behavior: the case of five developed countries’, Family Planning Perspectives, 33: 6, 251–8.Google Scholar
Southerton, D. (2002), ‘Boundaries of “us” and “them”: class, mobility and identification in a New Town’, Sociology, 36: 1, 171–93.Google Scholar
Stuber, J., Galea, S. and Link, B. (2008), ‘Smoking and the emergence of a stigmatized social status’, Social Science and Medicine, 67: 3, 420–30.Google Scholar
Thompson, L., Pearce, J. and Barnett, J. (2007), ‘Moralising geographies: stigma, smoking islands and responsible subjects’, Area, 39: 4, 508–17.Google Scholar
Tinkler, P. (2001), ‘“Red tips for hot lips”: advertising cigarettes for young women in Britain, 1920–70’, Women's History Review, 10: 2, 249–72.Google Scholar
Troyer, R. and Markle, G. (1983), Cigarettes: The Battle over Smoking, New Brunswick: Rutgers University Press.Google Scholar
Tyler, I. (2008), ‘ChavMum chav scum: class disgust in contemporary Britain’, Feminist Media Studies, 8: 1, 1734.Google Scholar
Urbandictionary (2003), 1st entry for ‘chav’, [accessed 12 March 2011].Google Scholar
Wald, N. and Nicolaides-Bouman, A. (1991), UK Smoking Statistics, Oxford: Oxford University Press.Google Scholar
Wardle, H., Pickup, D., Lee, L., Hall, J., Pickering, K., Grieg, K., Moodie, C. and MacKintosh, A.-M. (2010), Evaluating the Impact of Picture Health Warnings on Cigarette Packets, [last accessed 4 September 2010].Google Scholar
Weis, L. (ed.) (2008), The Way Class Works: Readings on School, Family and the Economy, London: Routledge.Google Scholar
World Bank (2003), Tobacco Control at a Glance, Washington, DC: World Bank.Google Scholar
World Health Organisation (WHO) (2008), WHO Report on the Global Tobacco Epidemic, Geneva: WHO.Google Scholar