Shaming smokers doesn't work, say researchers
Wednesday, February 13, 2019 at 13:48
Simon Clark

Interesting report on the BBC News website yesterday:

Mothers-to-be who smoke or drink could be hiding their habits in private - because of negative reactions, a study has found.

You think so?

The study claimed women who smoke or drank during pregnancy said they had "awkward" relationships with their midwives and would receive health advice in a "judgemental tone", making them less likely to seek support.

Dr Aimee Grant, from Cardiff University's Centre for Trials Research, said:

“Moral judgements are commonly directed towards mothers through reference to health behaviour in pregnancy, and working-class mothers are particularly subject to this criticism, ignoring the challenges of living on a low income.

“Our study shows that these looks and comments - including by members of the public - irritate and alienate pregnant women, making them less likely to seek help. No one wants to be judged and shamed."

Dr Dunla Gallagher, also from the study team, said smoking is a "coping strategy" for some low-income, expectant mothers.

She said: "Rather than stigma, women need empathy and a recognition of the challenges that pregnancy can bring in terms of women's independent choices."

Empathy for smokers, pregnant or otherwise, has of course been in short supply for years.

In 2004 the Labour health minister John Reid argued that for a young single mother living on a sink estate, a cigarette might be one of the few pleasures she had.

According to the Guardian:

Mr Reid said that the middle classes were obsessed with giving instruction to people from lower socio-economic backgrounds and that smoking was not one of the worst problems facing poorer people.

“I just do not think the worst problem on our sink estates by any means is smoking, but it is an obsession of the learned middle class," he said. "What enjoyment does a 21-year-old single mother of three living in a council sink estate get? The only enjoyment sometimes they have is to have a cigarette."

A former heavy smoker who was member of parliament for one of the poorest constituencies in the country, Reid almost certainly knew what he was talking about, but it didn’t stop the middle class puritans in public health venting their fury at his heretical statement.

Since then successive governments, egged on by those same joyless campaigners, have embarked on a relentless campaign to denormalise not just smoking but smokers as well.

They have shown not a jot of empathy or compassion for people who choose to smoke, not even those for whom smoking offers a brief moment of respite from life’s daily challenges.

Every increase in tobacco duty, for example, is applauded despite the fact that it's designed to make life harder for the less well off in the hope that it will force them to quit.

If they continue to smoke anti-smoking campaigners then have the nerve to argue that smoking is forcing people further into poverty, washing their hands of any responsibility for this shameful state of affairs.

Current targets include pregnant women and hospital patients who smoke. The aim is to stigmatise both groups until they too succumb to the pressure to quit.

I’m pleased therefore that the Cardiff study highlights not only the lack of empathy for mothers-to-be who smoke but also notes that the 'negative feedback' from midwives and anti-smoking partners doesn't seem to have much impact apart from irritating and alienating them.

There’s a reason for this and it’s called human nature. People don’t like being nagged or bullied and the natural inclination is to rebel, in this instance quietly and in private.

Of course, driven by their innate sense of superiority, anti-smoking zealots are unlikely to change their strategy any time soon.

Meanwhile another report currently doing the rounds blames budget cuts for eroding ‘the support (sic) pregnant women need to stop smoking’.

Recent headlines include ‘The shocking number of pregnant women smoking in Liverpool’, ‘Thousands of pregnant Brummie women are STILL smoking’ and ‘A sixth of women in North East still smoke when they give birth’.

The aim of this campaign is, I imagine, two-fold:

One, it maintains the pressure on pregnant women to stop smoking; two, it politicises the issue by turning it into a debate about money.

According to Elizabeth Duff, senior policy adviser for the National Childbirth Trust:

“Smoking cessation support is now being funded under local authorities as opposed to public health.

“We know that local authority budgets cuts have eroded the support that women need and that’s why we’re seeing little progress.”

There's a simple reason why councils are cutting budgets for stop smoking services and it's this.

Since 2010 the number of smokers using smoking cessation services to help them quit has dropped by over 50 per cent.

This is partly because there are fewer smokers who want to quit, and partly because many of those that do are doing it for themselves – by switching to vaping, for example.

Instead of bemoaning the reduction in funding, tobacco control campaigners should look closer to home and stop demonising smokers because it's clearly counter-productive.

Better still they should show some empathy and allow adults to make their own choices without fear of stigmatisation or worse.

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