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An increase in the social unacceptability of smoking has dramatically decreased tobacco use in the USA. However, how policies (e.g., smoke free air laws) and social factors (e.g., social norms) drive the social unacceptability of tobacco use are not well understood. New research suggests that the stigmatization of smokers is an unrecognized force in the tobacco epidemic and could be one such mechanism. Thus, it is important to investigate the sources of smoker-related stigmatization as perceived by current and former smokers. In this study we draw on the broader literature about stigma formation in the context of the tobacco epidemic and examine the role of attribution, fear, tobacco control policies, power and social norms in the formation of smoker-related stigma. We test hypotheses about the determinants of stigma using a population-based sample of 816 current and former smokers in New York City. The results show that perceptions of individual attributions for smoking behavior and fear about the health consequences of second hand smoke are important influences on smoker-related stigmatization. Structural forms of discrimination perpetrated against smokers and former smokers (e.g., company policies against hiring smokers) are also related to smoker-related stigma. Respondents with more education perceive more smoker-related stigma than respondents with less education and, Black and Latino respondents perceive less smokerrelated stigma than White respondents. Social norms, specifically family and friends' expressed disapproval of smoking, contribute to the formation of smoker-related stigma. These findings suggest important points of leverage to harness the powerful role of stigma in the smoking epidemic and raise concerns about the possible role of stigma in the production of smoking disparities.

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The AIDS epidemic has borne witness to the terrible burdens imposed by stigmatization and to the way in which marginalization could subvert the goals of HIV prevention. Out of that experience, and propelled by the linkage of public health and human rights, came the commonplace assertion that stigmatization was a retrograde force.Yet, strikingly, the antitobacco movement has fostered a social transformation that involves the stigmatization of smokers. Does this transformation represent a troubling outcome of efforts to limit tobacco use and its associated morbidity and mortality; an ineffective, counterproductive, and moralizing approach that leads to a dead end; or a signal of public health achievement? If the latter is the case, are there unacknowledged costs?

Objective. This study examines the association between discrimination due to race and other attributes (e.g., sex, age) and self-assessed mental and physical health among Latinos and blacks. Data Source. Latino and black adult participants (n 5 873) identified by random digit dialing were interviewed by telephone in four low-income neighborhoods in New York City: the South Bronx, East Harlem, Central Harlem, and Bedford-Stuyvesant. Study Design. In this cross-sectional study, generalized estimating equations were used to fit multilevel multivariable models to test the association between discrimination and poor mental and physical health while controlling for socioeconomic status, access to health care, social support, smoking, and the racial and ethnic composition of each neighborhood. Principal Findings. Discrimination due to race and discrimination due to other attributes were associated with poor self-assessed mental but not physical health in separate multivariable models. Persons who experienced multiple domains of discrimination had a greater probability of reporting poor mental health than persons who experienced no discrimination. Conclusions. Discrimination due to race and other attributes was a significant correlate of mental health among Latinos and blacks independent of other accepted determinants of health.

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Parents' own level of posttraumatic stress was associated with whether their children received counseling related to the September 11 attacks. This finding has important implications, because parents act as decision makers for their children in seeking health care. After the terrorist attacks, school and health care personnel provided early intervention counseling in Manhattan.