A new Gallup poll reveals that the percentage of Americans who have less respect for smokers has increased markedly since 1994 and greatly exceeds the percentage of people who have less respect for persons who are obese.
In the 2011 poll, 25% of Americans reported that they have less respect for people who smoke, while 12% stated that they have less respect for people who are obese. In 1994, only 14% of Americans answered that they had less respect for smokers. That percentage has increased steadily since then, and increased from one in five to one in four over the past eight years.
When only lifetime nonsmokers are considered, the numbers are even more striking. One-third of people who have never smoked responded that they have less respect for smokers. Disrespect for smokers was associated with a person having higher levels of education and income.
The Rest of the Story
While the poll itself does not provide an evaluation of the reasons for the increasing lack of respect for smokers, I believe that changes in the anti-smoking movement have been a major contributor.
For example, there has been a change in the movement from a focus on attacking "smoke" to attacking the "smoker." Many anti-smoking groups are supporting policies to not only remove tobacco smoke from the workplace, but also to remove smokers. Hospitals in particular are leading the trend in refusing to allow smokers to enter the workforce. Some anti-smoking groups are promoting refusal of medical care to smokers, removal of children from homes with smokers under certain conditions, and ineligibility of smokers to adopt or foster children.
The key tenet to all of the above anti-smoking policies is that smoking is a stupid decision that is entirely under the control of the smoker and that no person with any degree of intelligence would make such a decision. This premise goes completely against the central theme of the anti-tobacco movement at the time I entered the movement, which was that smoking is an addiction and that smokers are in a sense victims of the tobacco industry's brilliant marketing and the addictive nature of the product and the behavior, rather than a result of stupid decision-making.
I entered the tobacco control movement largely because I wanted to help my many patients who were smokers and were suffering from chronic and often debilitating diseases. I witnessed the toll that smoking takes on health directly during my medical school years and also during my internship and residency. During that time, I decided to dedicate my career to try to prevent the suffering caused by smoking-related disease. Never would I have dreamed at that time that the movement would eventually become an attack on smokers, rather than a movement which sympathized with and was dedicated to helping smokers.
The tobacco control movement needs to re-think where it is and the direction in which it is going. In light of these new data from Gallup, we need to think carefully about whether this is really where we want to be. Are we really trying to engender a disrespect for smokers? Do we really want the public to view smoking as nothing more than a poor decision on the part of adults?
In many ways, the success of the tobacco control movement has been attributable, I think, to our success in framing smoking as an addiction, emphasizing that most smokers begin smoking as youth, explaining that youth are not making fully informed decisions, and recognizing that once addicted as a youth, it is very difficult to quit. It is not as simple as just blaming smokers for making a poor decision and not having the intelligence or will to change their behavior.
Nor should smoking be viewed as a moral issue or as one of character in the first place. Smoking should be viewed as a consumer behavior, much like the purchase of any other product which affects one's health, and the role of the tobacco corporations in marketing the product and designing it in a way to maximize its addictive power should be the focus of our educational, program, and policy actions.
The Gallup poll results should be viewed as a bad report card for the tobacco control movement. In lieu of requiring our parent to sign this bad report card, my hope is that the movement will reconsider the direction that the program is going and make immediate changes to alter our course.