The ironic effects of stigmatizing smoking: combining stereotype threat theory with behavioral pharmacology

Cortland, Clarissa; Shapiro, Jenessa R.; Guzman, Iris; Ray, Lara A.

doi:10.1111/add.14696

Cited by 18 publications

(8 citation statements)

References 50 publications

(67 reference statements)

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“…With respect to smoking, smokers with a high smoking identity who had their stigmatized status revealed in a mock interview (Helweg-Larsen, Sorgen, & Pisinger, 2019) or viewed a stigmatizing smoking public service announcement (Kim, Cao, & Meczkowski, 2018) decreased their interest in smoking cessation. Similarly, smokers who were reminded of their devalued status were less able to resist smoking (Cortland, Shapiro, Guzman, & Ray, 2019). Thus, research on the effect of stigma on smoking behaviors has produced mixed findings.…”

mentioning

confidence: 99%

Reminders of a stigmatized status might help smokers quit.

Helweg‐Larsen

Pyakuryal

Pisinger³

2020

Stigma and Health

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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.

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confidence: 99%

Reminders of a stigmatized status might help smokers quit.

Helweg‐Larsen

Pyakuryal

Pisinger³

2020

Stigma and Health

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“…However, motivating intentions through increased risk perception among smokers may be difficult. Previous studies have demonstrated that risk communication interventions for individuals who have received threat-based messages about behavior over extended periods (eg, heavy smokers) may have a limited effect [ 45 , 46 ]. By focusing on cancer treatment efficacy rather than repeating the common negative physiological effects of smoking, the risk message frame seemed more successful in increasing seeking intention.…”

Section: Discussionmentioning

confidence: 99%

A Multimethod Evaluation of Tobacco Treatment Trial Recruitment Messages for Current Smokers Recently Diagnosed With Cancer: Pilot Factorial Randomized Controlled Trial

Neil¹,

Senecal²,

Ballini³

et al. 2022

JMIR Cancer

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Background A cancer diagnosis can catalyze motivation to quit smoking. Tobacco treatment trials offer cessation resources but have low accrual rates. Digital outreach may improve accrual, but knowledge of how best to recruit smokers with recent diagnoses is limited. Objective This study aims to identify the message frames that were most effective in promoting intent to talk to a physician about participating in a tobacco treatment trial for smokers recently diagnosed with cancer. Methods From February to April 2019, current smokers diagnosed within the past 24 months were recruited from a national web-based panel for a multimethod pilot randomized trial (N=99). Participants were randomized to a 2×3 plus control factorial design that tested 3 unique message frames: proximal versus distal threats of smoking, costs of continued smoking versus benefits of quitting, and gains of participating versus losses of not participating in a tobacco treatment trial. The primary outcome was intent to talk to a physician about participating in a tobacco treatment trial. In phase 1, the main effect within each message factor level was examined using ANOVA and compared with the control condition. Other message evaluation and effectiveness measures were collected and explored in a multivariable model predicting intent to talk to a physician. In phase 2, open-text evaluations of the messages were analyzed using natural language processing software (Leximancer) to generate a thematic concept map and Linguistic Inquiry Word Count to identify and compare the prevalence of linguistic markers among message factors. Results Of the 99 participants, 76 (77%) completed the intervention. Participants who received the cost of continued smoking frame were significantly more likely to intend to talk to their physician about participating in a tobacco treatment trial than those who received the benefits of the quitting frame (mean costs 5.13, SD 1.70 vs mean benefits 4.23, SD 1.86; P=.04). Participants who received the proximal risks of continued smoking frame were significantly more likely to seek more information about participating (mean distal 4.83, SD 1.61 vs mean proximal 5.55, SD 1.15; P=.04), and those who received the losses of not participating frame reported significantly improved perceptions of smoking cessation research (mean gain 3.98, SD 0.83 vs mean loss 4.38, SD 0.78; P=.01). Male participants (P=.006) and those with greater message relevancy (P=.001) were significantly more likely to intend to talk to their physician. Participants’ perceptions of their smoking habits, as well as their motivation to quit smoking, were prevalent themes in the open-text data. Differences in the percentages of affective words across message frames were identified. Conclusions Multimethod approaches are needed to develop evidence-based recruitment messages for patients recently diagnosed with cancer. Future tobacco treatment trials should evaluate the effectiveness of different message frames on smoker enrollment rates. Trial Registration Clinicaltrials.gov NCT05471284; https://clinicaltrials.gov/ct2/show/NCT05471284

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“…This behavioral task measures the motivation to smoke under conditions in which avoiding smoking is monetarily rewarded [44,45]. Participants received a tray containing eight cigarettes of their preferred brand, a lighter and an ashtray.…”

Section: Smoking Lapse Analogue Taskmentioning

confidence: 99%

Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans

et al. 2020

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Background and Aims Frequent experiences of discrimination could increase vulnerability to tobacco withdrawal and smoking lapse in populations subject to tobacco‐related health disparities. This laboratory study (2013–17) examined whether individual differences in perceived exposure to discrimination in one's daily life predicted tobacco withdrawal symptoms and smoking lapse behavior following acute tobacco deprivation in African American smokers. Design Mixed design with the between‐subjects continuous variable of perceived discrimination crossed with the within‐subject variable of tobacco deprivation status (deprived versus non‐deprived). Setting Academic medical center in Los Angeles, CA, USA. Participants African American non‐treatment seeking daily cigarette smokers (n = 607, ≥ 10 cig/day). Measurements At a baseline visit, self‐reported frequency of perceived exposure to discrimination in one's daily life was measured [everyday discrimination scale (EDDS)]. At two subsequent counterbalanced experimental visits (16‐hour tobacco deprivation versus ad‐libitum smoking), self‐report assessments of various tobacco withdrawal symptom domains [Brief Questionnaire of Smoking Urges), Wisconsin Smoking Withdrawal Scale (WSWS), Profile of Mood States (POMS), Snaith–Hamilton Pleasure Scale (SHAPS) and Current Impulsivity Scale (CIS)) and a behavioral smoking lapse analogue task were measured. Findings Adjusted models demonstrated that greater frequency of perceived exposure to discrimination was associated with larger deprivation‐induced increases in acute urges to smoke to alleviate negative mood, several negative mood states and subjective cognitive functioning—effect sizes were small in magnitude (βs = 0.09–0.13; Ps < 0.02). Data were inconclusive for associations between perceived exposure to discrimination and deprivation‐induced changes in cravings, urges to smoke for pleasure, positive mood reduction, other symptoms or smoking reinstatement behavior. Conclusions Frequency of perceived exposure to discrimination appears to be modestly associated with increased severity of some deprivation‐induced tobacco withdrawal symptoms in African American smokers.

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The ironic effects of stigmatizing smoking: combining stereotype threat theory with behavioral pharmacology

Cited by 18 publications

References 50 publications

Reminders of a stigmatized status might help smokers quit.

Reminders of a stigmatized status might help smokers quit.

A Multimethod Evaluation of Tobacco Treatment Trial Recruitment Messages for Current Smokers Recently Diagnosed With Cancer: Pilot Factorial Randomized Controlled Trial

Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans

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