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The effect of school smoke-free policies on smoking stigmatization: A European comparison study among adolescents

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Listed:
  • Pierre-Olivier Robert
  • Adeline Grard
  • Nora Mélard
  • Martin Mlinarić
  • Arja Rimpelä
  • Matthias Richter
  • Anton E Kunst
  • Vincent Lorant

Abstract

The increasing denormalization of smoking by tobacco control policies and a normative smoke-free climate may shift power towards adolescent non-smokers. It is unclear, however, how common stigmatization of smokers is among adolescents or how stigmatization relates to the denormalization of smoking in their school and social environment. This paper aims to measure (1) whether stigmatization among European adolescents varies according to smoking status and socioeconomic position (SES), and (2) whether stigmatization is greater in school environments in which smoking is denormalized (i.e. those with low smoking rates and strong school tobacco policies). Data on 12,991 adolescents were collected in 55 schools in seven European countries (SILNE R-survey, 2016/17). We applied Stuber’s adapted scale of perceived stereotyping and discrimination towards smokers to smoking status and five variables indicating a power shift towards non-smokers: the school’s tobacco control policy (STP) score, the percentage of adolescents in the school who smoke, parents’ level of education, students’ academic performance, and the percentage of their friends who smoke. Multilevel regressions were applied to the global score for perceived stigmatization. Discrimination against smokers and stereotyping of smokers were frequently reported. Smokers reported less ‘perceived stigmatization of smoking’ than non-smokers (Beta = -0.146, p

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  • Pierre-Olivier Robert & Adeline Grard & Nora Mélard & Martin Mlinarić & Arja Rimpelä & Matthias Richter & Anton E Kunst & Vincent Lorant, 2020. "The effect of school smoke-free policies on smoking stigmatization: A European comparison study among adolescents," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-15, July.
    • Handle: RePEc:plo:pone00:0235772
    DOI: 10.1371/journal.pone.0235772
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    References listed on IDEAS

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    1. Stuber, Jennifer & Meyer, Ilan & Link, Bruce, 2008. "Stigma, prejudice, discrimination and health," Social Science & Medicine, Elsevier, vol. 67(3), pages 351-357, August.
    2. Burris, Scott, 2008. "Stigma, ethics and policy: A commentary on Bayer's "Stigma and the ethics of public health: Not can we but should we"," Social Science & Medicine, Elsevier, vol. 67(3), pages 473-475, August.
    3. Wiehe, S.E. & Aalsma, M.C. & Liu, G.C. & Fortenberry, J.D. & Stultz, L., 2010. "Gender differences in the association between perceived discrimination and adolescent smoking," American Journal of Public Health, American Public Health Association, vol. 100(3), pages 510-516.
    4. Berridge, Virginia, 1999. "Passive smoking and its pre-history in Britain: policy speaks to science?," Social Science & Medicine, Elsevier, vol. 49(9), pages 1183-1195, November.
    5. Evans-Polce, Rebecca J. & Castaldelli-Maia, Joao M. & Schomerus, Georg & Evans-Lacko, Sara E., 2015. "The downside of tobacco control? Smoking and self-stigma: A systematic review," Social Science & Medicine, Elsevier, vol. 145(C), pages 26-34.
    6. Voigt, K., 2012. "Ethical concerns in tobacco control nonsmoker and "nonnicotine" hiring policies: The implications of employment restrictions for tobacco control," American Journal of Public Health, American Public Health Association, vol. 102(11), pages 2013-2018.
    7. Stuber, Jennifer & Galea, Sandro & Link, Bruce G., 2008. "Smoking and the emergence of a stigmatized social status," Social Science & Medicine, Elsevier, vol. 67(3), pages 420-430, August.
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    2. Ball, Jude & Grucza, Richard & Livingston, Michael & ter Bogt, Tom & Currie, Candace & de Looze, Margaretha, 2023. "The great decline in adolescent risk behaviours: Unitary trend, separate trends, or cascade?," Social Science & Medicine, Elsevier, vol. 317(C).

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