No abstract

Stigma is a social construction that defines people in terms of a distinguishing characteristic or mark, and devalues them as a consequence. Stigma occurs when society labels someone as tainted, less desirable, or handicapped. There is emerging evidence that chronic obstructive pulmonary disease (COPD) is a physical condition with social consequences. The valuing, and devaluing, of individuals within society are social judgments that have roots in sociocultural values and beliefs. Cultural norms and values dictate the distinct roles and behaviors that are expected of men and women in a given culture. Social reactions to individuals with COPD can have an effect on their illness experience. This article explores the relationships between COPD and stigma and gender, particularly how these key elements may interact to affect experiences of individuals with COPD within their social milieu. The aim of this article is to begin to set out questions and issues that require further empirical exploration. The stigma of COPD arises because people are held responsible for their disease, are noted to have engaged in a stigmatized behavior (smoking), are marked with oxygen equipment and bodily changes, and experience a disruption in their social interactions.

General practitioners are often exhorted to routinely counsel patients who smoke about quitting in light of current evidence-based medicine (EBM) guidelines suggesting that such brief interventions provide an easy and effective way of increasing quit rates. Drawing on semi-structured interviews conducted with 25 smokers and 10 general practitioners (GPs) in British Columbia, Canada, this article explores smokers' and GPs' perspectives on smoking cessation interventions in primary care settings. Study findings indicate that both patients and GPs believe smoking is best broached when it is patient-initiated or raised in the context of smokingrelated health issues, and there was a broader consensus that the role of doctors is to provide education and information rather than coercing smokers to quit. However, smokers wanted further recognition of the difficulties of quitting smoking and many questioned the competence of GPs to deal with addiction-related issues. Similar barriers to smoking cessation were raised by smokers and GPs -primarily inadequate time and resources. Based on these findings, we argue that the assumption that primary care consultations provide an important venue for encouraging smokers to quit deserves reconsideration based on the complexity of this issue, the circumstances in which most GPs practice, and the danger of alienating smokers. Questions are raised about whether current EBM guidelines are an adequate tool for guiding individual clinical interactions between GPs and smokers.

No abstract

No abstract