Smoking, Stigma and Social Class

The decline in cigarette smoking in high-income countries is attributed to the increasing social unacceptability of smoking, a cultural shift in which tobacco control policies are identified as playing a major part. While seen as essential to protect public health, there is a growing appreciation that these polices may have contributed to a social climate in which smoking is stigmatised. The paper reviews this debate on smoking and stigma. It notes that individuals are represented by their smoking status; other social differences are typically treated as secondary. Thus, while the links between disadvantage and smoking are acknowledged, social class remains on the margins of the debate. The paper argues instead that class provides an essential analytic lens through which to understand the stigma of smoking and the stigmatising impacts of tobacco control policies. In support of its argument, it discusses how the stigmatisation of smoking has occurred against a backdrop of widening socioeconomic differentials in smoking and the increasing importance of the body and behaviour in public discourses about social class and moral worth. The paper concludes by underlining the importance of embedding tobacco control research and policy in an appreciation of social class, and social inequalities more broadly.