Crittendon Denine R, Brecher Alison C, Okere Samantha, Hass Richard, Frasso Rosemary, Brawer Rickie, Zeigler-Johnson Charnita
College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.
Fox Chase Cancer Center, Philadelphia, PA, USA.
Nicotine Tob Res. 2025 May 22;27(6):1073-1082. doi: 10.1093/ntr/ntae127.
African Americans/Blacks (AAB) are at increased risk for morbidity and mortality from smoking-related diseases including lung cancer (LC). Smoking stigma is believed to be a primary barrier to health care-seeking for people who smoke. Previous studies illustrate that perceptions of smoking vary across populations. However, little is known about the prevalence of smoking stigmas among AAB. The purpose of this study was to increase understanding of the perception of cigarette smoking by AAB.
We conducted free-listing interviews in which individuals listed all-thoughts and feelings regarding smoking and health-related questions with a convenience sample of eligible AAB adults (n = 58) in the Philadelphia region. Additionally, we collected participant self-reported demographic data. Data were cleaned and the salience of each term was computed using Anthropac. Graphical methods were then used to determine salient responses across groups stratified by gender, age, education, and smoking status.
The sample had a median age of 51 years and was 67.2% female. Most participants had completed college (58.6%) and had never smoked (74.1%). Regarding their perceptions of people who smoke cigarettes, results showed that "smelly," "health hazard," and "judgment" were the most salient terms among all-participants. Overall, "smelly" and "unhealthy" were salient for both males and females. However, "dental," "dirty," "addictive," and "habit" were also salient among males. Phrases such as "unhealthy" and "addictive" were primarily salient for older participants (>51 years) versus "smelly" for younger participants. The term "smelly" was salient among all-education levels. However, "unhealthy" was also salient among those with less than a 4-year college degree. Moreover, the terms "smelly" and "annoying" were most common among people who smoke as opposed to "health hazard" among people who don't smoke.
We observed that the most stigmatizing language was primarily associated with perceptions of negative social interactions, social judgment, and health-related concerns. Future studies are needed to explore how smoking-related stigmas impact patient adherence to smoking cessation programs and LC screening protocols.
Little is known about the prevalence of smoking stigmas among AAB. This study explores the AAB perspective of cigarette smoking and related stigmas. Among AAB, smoking is represented by stigmatizing language across gender, age groups, and smoking history. It is primarily associated with negative social interactions, social judgement, and health-related concerns indicating that smoking stigma is a concern for AAB individuals who smoke. Further research is warranted.
非裔美国人/黑人（AAB）因吸烟相关疾病（包括肺癌（LC））而发病和死亡的风险增加。吸烟耻辱感被认为是吸烟者寻求医疗保健的主要障碍。先前的研究表明，不同人群对吸烟的看法各不相同。然而，关于非裔美国人/黑人中吸烟耻辱感的患病率知之甚少。本研究的目的是加深对非裔美国人/黑人对吸烟看法的理解。
我们进行了自由列举访谈，让符合条件的非裔美国人/黑人成年人（n = 58）的便利样本列出所有关于吸烟及与健康相关问题的想法和感受。此外，我们收集了参与者自我报告的人口统计数据。对数据进行清理，并使用Anthropac计算每个术语的显著性。然后使用图形方法确定按性别、年龄、教育程度和吸烟状况分层的各组的显著反应。
样本的中位年龄为51岁，女性占67.2%。大多数参与者完成了大学学业（58.6%）且从未吸烟（74.1%）。关于他们对吸烟者的看法，结果显示，“有异味”“健康危害”和“评判”是所有参与者中最显著的术语。总体而言，“有异味”和“不健康”对男性和女性都很显著。然而，“牙齿问题”“脏”“上瘾”和“习惯”在男性中也很显著。“不健康”和“上瘾”等表述主要在年龄较大的参与者（>51岁）中显著，而“有异味”在较年轻的参与者中显著。“有异味”在所有教育水平中都很显著。然而，“不健康”在大学学历不足4年的人群中也很显著。此外，“有异味”和“令人讨厌”在吸烟者中最常见，而“健康危害”在不吸烟者中最常见。
我们观察到，最具耻辱性的语言主要与负面社会互动、社会评判以及与健康相关的担忧的看法有关。未来需要开展研究，以探讨与吸烟相关的耻辱感如何影响患者对戒烟计划和肺癌筛查方案的依从性。
关于非裔美国人/黑人中吸烟耻辱感的患病率知之甚少。本研究探讨了非裔美国人/黑人对吸烟及相关耻辱感的看法。在非裔美国人/黑人中，吸烟在不同性别、年龄组和吸烟史中都以耻辱性语言来体现。它主要与负面社会互动、社会评判以及与健康相关的担忧有关，这表明吸烟耻辱感是吸烟的非裔美国人/黑人个体所关心的问题。有必要进行进一步研究。
