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Smoking, Stigma and Social Class


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.

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Aaranovitch D. (2000), ‘Why I am so afraid of Paulsgrove woman’, The Independent, 11 August 2000.
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.
Bayer R. (2008), ‘Stigma and the ethics of public health: not can we but should we’, Social Science and Medicine, 67: 3, 463–72.
Bayer R. and Stuber J. (2006), ‘Tobacco control, stigma, and public health: rethinking the relations’, American Journal of Public Health, 96: 1, 4750.
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.
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.
Brandt A. (1990), ‘The cigarette, risk, and American culture’, Daedalus, 119: 4, 155–76.
Brandt A. (1997), ‘Behavior, disease, and health in the twentieth-century’, in Brandt A. M. and Rozin P. (eds.), Morality and Health, London: Routledge.
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.
Brandt A. (2007), The Cigarette Century, New York: Basic Books.
Breen R. and Rottman D. B. (1994), Class Stratification: A Comparative Perspective, Hemel Hempstead: Harvester Wheatsheaf.
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.
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.
Calder A. and Sheridan D. (eds.) (1984), Speak for Yourself: A Mass-Observation Anthology, 1937–49, London: Jonathan Cape.
Center for Disease Control and Prevention (CDC) (2010), Smoking Prevalence among US Adults, 1955–2007, from [last accessed 21 August 2010].
Chapman S. (1993), ‘Unravelling gossamer with boxing gloves: problems in explaining the decline in smoking’, British Medical Journal, 307: 429–32.
Chapman S. and Freeman B. (2008), ‘Markers of the denormalisation of smoking and the tobacco industry’, Tobacco Control, 17: 1, 2531.
Charlesworth S. (2000), A Phenomenology of Working Class Experience, Cambridge: Cambridge University Press.
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.
Craig R., Mindell J. and Hirani V. (2009), Health Survey for England 2008, London: The Information Centre
Davidson G. (2004), ‘Sites to check out if you chav what it takes’, Edinburgh Evening News, 4 February 2004.
Department of Health (DH) (2011), Healthy Lives, Healthy People: A Tobacco Control Plan for England, London: Department of Health.
Doll R. and Bradford Hill A. (1950), ‘Smoking and carcinoma of the lung: preliminary report’, British Medical Journal, 2: 739–48.
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.
Feldman E. and Bayer R. (eds.) (2004), Unfiltered: Conflicts over Tobacco Policy and Public Health, Cambridge, MA: Harvard University Press.
Finch L. (1993), The Classing Gaze: Sexuality, Class and Surveillance, St Leonards, NSW, Australia: Allen & Unwin.
Forey B., Hamling J., Lee P. and Wald N. (2002), International Smoking Statistics (2nd edn), Oxford: Oxford University Press.
Goffman E. (1963), Stigma: Notes on the Management of Spoiled Identity, Harmondsworth, Middlesex: Penguin.
Goldstein J. (1991), ‘The stigmatization of smokers: an empirical investigation’, Journal of Drug Education, 21: 2, 167–82.
Graham H. (2009a), ‘Women and smoking’, Drug and Alcohol Dependence, 104S: S11S16.
Graham H. (2009b), ‘Tackling health inequalities: the scope for policy’, in Graham H. (ed.), Understanding Health Inequalities, Buckingham: Open University Press.
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.
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.
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.
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.
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].
Hayward K. and Yar M. (2006), ‘The “chav” phenomenon: consumption, media and the construction of a new underclass’, Crime, Media, Culture, 2: 1, 928.
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.
Hilton M. (2000), Smoking in British Popular Culture, Manchester: Manchester University Press.
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.
Joosens L. and Raw M. (2006), ‘The tobacco control scale: a new scale to measure country activity’, Tobacco Control, 15: 247–53.
Kelly M. (2010), ‘Regulating the reproduction and mothering of poor women’, Journal of Poverty, 14: 7696.
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.
Lader D. (2009), Smoking-related Behaviour and Attitudes, 2008/09, London: Office for National Statistics.
Lawler S. (2005), ‘Disgusted subjects: the making of middle-class identities’, Sociological Review, 53: 3, 429–46.
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.
Link B. and Phelan J. (2009), ‘The social shaping of health and smoking’, Drug and Alcohol Dependence, 104: supplement 1, S6S10.
Link B. G. and Phelan J. (2001), ‘Conceptualising stigma’, Annual Review of Sociology, 27: 528–9.
Lopez A., Collishaw N. and Piha T. (1994), ‘A descriptive model of the cigarette epidemic in developed countries’, Tobacco Control, 3: 242–7.
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.
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.
Marsh A. and Matheson J. (1983), Smoking Attitudes and Behaviour, London: Office of Population Censuses and Surveys.
McKennell A. and Thomas R. (1967), Adults’ and Adolescents’ Smoking Habits and Attitudes, London: HMSO.
Mishel L., Bernstein J. and Allegretto S. (2007), The State of Working America, 2006–07, Ithica, NY: ILR Press.
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.
Müller W. and Gangl M. (eds.) (2003), Transitions from Education to Work in Europe, Oxford: Oxford University Press.
Office for National Statistics (ONS) (2001), Living in Britain: Results from the 2000 General Household Survey, London: Office for National Statistics.
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.
Petersen A. and Lupton D. (1996), The New Public Health: Health and Self in the Age of Risk, London: Sage.
Philip Morris International (1984), Interoffice correspondence, 7 April, [last accessed 4 September 2010].
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].
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.
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.
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.
Royal College of Phsyicians (RCP), (1962), Smoking and Health, London: Pitman Medical Publishing Company.
Savage M. (2000), Class Analysis and Social Transformation, Buckingham: Open University Press.
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.
Skeggs B. (1997), Formations of Class and Gender, London: Sage.
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.
Southerton D. (2002), ‘Boundaries of “us” and “them”: class, mobility and identification in a New Town’, Sociology, 36: 1, 171–93.
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.
Thompson L., Pearce J. and Barnett J. (2007), ‘Moralising geographies: stigma, smoking islands and responsible subjects’, Area, 39: 4, 508–17.
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.
Troyer R. and Markle G. (1983), Cigarettes: The Battle over Smoking, New Brunswick: Rutgers University Press.
Tyler I. (2008), ‘ChavMum chav scum: class disgust in contemporary Britain’, Feminist Media Studies, 8: 1, 1734.
Urbandictionary (2003), 1st entry for ‘chav’, [accessed 12 March 2011].
Wald N. and Nicolaides-Bouman A. (1991), UK Smoking Statistics, Oxford: Oxford University Press.
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].
Weis L. (ed.) (2008), The Way Class Works: Readings on School, Family and the Economy, London: Routledge.
World Bank (2003), Tobacco Control at a Glance, Washington, DC: World Bank.
World Health Organisation (WHO) (2008), WHO Report on the Global Tobacco Epidemic, Geneva: WHO.
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Journal of Social Policy
  • ISSN: 0047-2794
  • EISSN: 1469-7823
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