Saetta Sébastien, Kivits Joëlle, Frohlich Katherine, Minary Laetitia
Sante Publique. 2020 September-December;32(5):473-478. doi: 10.3917/spub.205.0473.
Tobacco control strategies, considered legitimate and effective, are rarely the subject of critical analysis in France. This is specifically true with regard to their potentially harmful effects, particularly against people who continue to smoke. This article introduces this debate, focusing on the potentially stigmatizing effects of anti-smoking policies. It has been attested by numerous international studies, and by a study in France, that the general process of tobacco denormalization has led to the stigmatization of smokers who then may be subject to discrimination. To the extent that smoking is now concentrated in the most disadvantaged socio-economic populations in France, the latter are thus more exposed to stigma. While underscoring the need to develop targeted interventions against them, this article also warns and calls for vigilance regarding the potential iatrogenic effects of these interventions. It is therefore necessary to develop research and evaluations on this subject in order to accurately measure the effects of these interventions, particularly in terms of stigmatization and self-stigma, and to ensure that public health actors do not generate more problems than they solve.
在法国，被认为合理且有效的烟草控制策略很少成为批判性分析的对象。尤其是在其潜在有害影响方面，特别是对那些继续吸烟的人而言，情况更是如此。本文引入了这场辩论，重点关注反吸烟政策可能产生的污名化影响。众多国际研究以及法国的一项研究均已证实，烟草去正常化的总体进程导致了吸烟者被污名化，进而可能遭受歧视。鉴于目前吸烟在法国最弱势的社会经济群体中更为集中，这些群体因此更容易受到污名化影响。在强调需要针对他们制定有针对性的干预措施的同时，本文也警告并呼吁对这些干预措施的潜在医源性影响保持警惕。因此，有必要开展关于这一主题的研究和评估，以便准确衡量这些干预措施的效果，特别是在污名化和自我污名化方面，并确保公共卫生行为者所引发的问题不超过他们所解决的问题。
