Reminders of a stigmatized status might help smokers quit.

Abstract

As members of a devalued group, it is not surprising that smokers experience stigmatization and discrimination. But it is not clear whether smokers react to these experiences by moving toward or away from their group membership and identity as smokers. Guided by the identity threat model of stigma (Major & O'Brien, 2005), we examined the process of stigmatization and its emotional, cognitive, attitudinal, and behavioral consequences. We experimentally examined how reading a stigmatizing newspaper article or a control article (Experiment 1) and recalling one's experience with smoking discrimination or a control prompt (Experiment 2) affected smokers' responses. We also examined the role of cultural contexts (United States vs. Denmark; only in Experiment 1) and smoking identity. In Experiment 1, we used a community sample of smokers from the United States (N ϭ 111) and Denmark (N ϭ 111). We found that reading the stigmatizing article (compared with the control) caused more rejection sensitivity (U.S. participants only) and more intentions to quit smoking (both U.S. and Danish participants) for smokers low in smoking identity. In Experiment 2, we used an online sample of 194 U.S. smokers and found that recalling instances of mistreatment made smokers more stressed, rejection sensitive, and interested in smoking cessation when smokers appraised the stigma cue as threatening. Thus, we generally found that identity threat moved smokers toward leaving their stigmatized group (e.g., quitting smoking) rather than away from it. Our studies highlight the importance of understanding the psychological process by which smokers distance themselves from their spoiled identity.

Does ostracism help smokers quit?

“…But instead, ostracism led smokers toward cognitions, attitudes, and intentions associated with quitting smoking and thus leaving their devalued identity as smokers. Overall, the findings are consistent with our predictions as well as previous research which showed that when smokers recalled actual experiences of smoking stigma (and felt their identity was threatened) they reacted with stress, rejection sensitivity, and interest in quitting (Helweg-Larsen et al, 2020).…”

“…There were no effects (direct or indirect) for the DVs of smoking cessation intentions, self-efficacy, or time spent on the webpage. This is consistent with past research (e.g., Helweg-Larsen et al, 2020) and for ease of presentation, we did not include the null results in Table 2 and Figure 2.…”

“…Using G * Power (version 3.1.9.4), we selected the "Analysis of covariance (ANCOVA): Fixed effects, main effects, and interactions" option, set the effect size at f = .20, power to .80, alpha to .05, the numerator df to 1 (testing for a three-way interaction approximating the mediational model) and the number of groups to 8. We found that we needed 199 participants in total and based on the dropout rates from previous research (Helweg-Larsen et al, 2020), we aimed at getting 340 participants. Once our recruitment goal was reached, we stopped collecting data, and only then began analyzing the data.…”

“…The Smoking Rejection Sensitivity scale measures smokers' rejection sensitivity following exposure to a potentially stigmatizing situation (Helweg-Larsen et al, 2020). The shortened scale consists of four situations: Strangers coughing when walking by one's smoke, a coworker commenting on the high price of cigarettes, a person asking to switch to a different seat on a flight, and a nurse asking about one's smoking.…”

“…Importantly, because smokers can cope with stigma by leaving or intending to leave their devalued group (i.e., they have permeable group boundaries; Jetten et al, 2018), a key question is whether the resulting stress and cognitive depletion are associated with smoking-related attitudes and intentions that push smokers toward leaving or staying in their devalued group. One study directly testing the model found that when smokers were reminded or recalled personal instances of smoking stigmatization, they were more stressed, but also more rejection sensitive and interested in quitting (Helweg-Larsen et al, 2020). Thus, it appears that in certain circumstances, the stress resulting from stigmatization (identity threat) leads to coping associated with more positive health-related outcomes such as quitting.…”