The effects of stigmatizing US and Danish smokers

 描述（由申请人提供）：人们经常羞辱吸烟者，许多公共卫生信息也是如此。污名化也被提议作为减少吸烟流行率的一项公共卫生战略。但是，污名化真的会促使戒烟吗？还是会产生相反的效果？这个问题的答案对健康教育计划、戒烟计划和公共卫生政策有重要意义。我们对吸烟者如何应对污名化及其因果关系知之甚少。特别是研究不足的是社会背景下，如文化和社会地位的耻辱的反应。在拟议的研究中，在污名诱导的身份威胁模型的指导下，在美国和丹麦进行的两项实验研究将研究污名化吸烟者对不同社会地位的人的影响。身份威胁（污名化）将诱导吸烟者通过激活吸烟污名化的关注;在研究1中，通过在招聘情况下使污名化可见，在研究2中，通过提醒吸烟者，人们发现香烟烟雾和吸烟者恶心。污名化的影响预计会导致吸烟者经历情感，行为，认知和态度的影响，从而降低他们吸烟的可能性。 戒烟（具体目标1）。具体而言，污名化预计会导致吸烟者经历更大的生理压力（研究1），更大强度的吸烟（研究2），经历更大的认知耗竭，有更有利的吸烟态度，并最大限度地减少吸烟对个人健康的风险（研究1和2）。文化和社会阶层有望减弱这些影响（具体目标2）。具体而言，与美国吸烟者相比，丹麦吸烟者对污名化的反应更强烈（因为吸烟在丹麦的道德性较低，丹麦吸烟者更强烈地拒绝污名化），与社会地位较低的吸烟者相比，社会地位较高的吸烟者反应更强烈（因为吸烟在社会地位较高的群体中不太常见，社会地位较高的吸烟者拒绝暗示的降级到较低的社会地位）。这项研究将为污名化的后果提供有价值的见解，从而为更有效的教育干预和戒烟计划奠定基础。了解文化和阶级对污名化的反应在美国尤为重要，因为美国有大量不同的移民和难民人口，而且受教育程度较低的人吸烟率居高不下。因此，这项研究将有助于实现2020年健康人群的目标，即将美国成年人吸烟率从2012年的18%降至12%。

 DESCRIPTION (provided by applicant): People often stigmatize smokers and many public health messages are stigmatizing. Stigmatization has also been proposed as a public health strategy to decrease smoking prevalence. But does stigmatization actually motivate quitting, or does it have the opposite effect? The answer to this question has important implications for health education programs, smoking cessation programs, and public health policy. We know little about how smokers react to stigmatization and the causal consequences. Particularly understudied are reactions to stigma within social contexts, such as culture and social status. In the proposed research, guided by the Model of Stigma Induced Identity Threat, two experimental studies in the US and Denmark will examine the effects of stigmatizing smokers among people of various levels of social status. Identity threat (stigmatization) will be induced i smokers by activating concerns about smoking stigma; in Study 1 by making the stigma visible in a hiring situation and in Study 2 by reminding smokers that people find cigarette smoke and smokers disgusting. The effects of stigmatization are expected to cause smokers to experience emotional, behavioral, cognitive, and attitudinal effects that reduce the likelihood that they will quit smoking (Specific Aim 1). Specifically, stigmatization is expected to result in smokers experiencing greater physiological stress (Study 1), smoke with greater intensity (Study 2), experience greater cognitive depletion, have more favorable smoking attitudes, and minimize their personal health risk from smoking (Studies 1 and 2). Culture and social class are expected to attenuate these effects (Specific Aim 2). Specifically, Danish smokers will react more strongly to stigmatization compared to US smokers (because smoking is less moralized in Denmark and Danish smokers reject stigmatization more strongly) and smokers of higher social status will react more strongly compared to smokers of lower social status (because smoking is less common among members of higher social status groups and higher status smokers reject the implied demotion to a lower social status). This research will provide valuable insights into the consequences of stigmatization and thus lay the groundwork for more effective educational interventions and smoking cessation programs. Understanding cultural and class-based reactions to stigmatization is particularly important in the US with its large and diverse immigran and refugee populations as well as persistent high rates of smoking among people with less education. Thus, this research will contribute to reaching the Healthy People 2020 objective of reducing adult cigarette smoking in the US to 12% from the 2012 rate of 18%.