Cigarette smoking as a stigma: Evidence from France

Background: There is growing evidence that cigarette smoking has become a stigmatized behaviour, at least in western countries, and there is ongoing debate among experts about whether or not such stigma should be an instrument of anti-tobacco policy. Methods: We investigated French non-smokers attitudes toward cigarette smokers, using data from a telephone survey carried out in 2010 among a representative random sample of non-smokers aged 15-75 (N = 3091). We carried out a cluster analysis to build contrasted attitudinal profiles and we also computed a score of stigmatization. Results: We found evidence for the existence of stigma associated with cigarette smoking in France: a majority of French non-smokers would not date a smoker, nor hire one to take care of their children. The cluster analysis identified four contrasting profiles, corresponding to different levels of stigmatization, including one cluster whose respondents demonstrated strong levels of moral condemnation and social rejection of smokers. Older people, those with a lower educational level and those reporting financial difficulties were more prone to stigmatize smokers, while those who reported that somebody smoked in their home were less likely to do so. Those who had never smoked and those who abstained from alcohol were more prone to stigmatize smokers. Obese people were also more likely to do so (in bivariate analysis only). Conclusion: The process of tobacco stigmatization seems well-advanced in France, despite a cultural context that may be less permeable to this process. Further research is needed as our results raise some questions regarding its efficiency as a policy tool. First, people who are familiar with smokers are less prone to stigmatize them. More generally, simultaneously stigmatizing several categories of people may provide each of these same categories with stereotyped 'others' onto whom they can deflect their stigma. (C) 2013 Elsevier B.V. All rights reserved.