It isn't your imagination--they really are out to get you

[Vocalek]

Tob Control 2008;17:25-31 doi:10.1136/tc.2007.021386

• Research paper

[h=1]Markers of the denormalisation of smoking and the tobacco industry[/h]S. Chapman and B. Freeman

Background: In nations with histories of declining smoking prevalence and comprehensive tobacco control policies, smoking-positive cultures have been severely eroded. Smoking, smokers and the tobacco industry are today routinely depicted in everyday discourse and media representations in a variety of overwhelmingly negative ways. Several authors have invoked Erving Goffman’s notions of stigmatisation to describe the process and impact of this radical transformation, which importantly includes motivating smoking cessation. Efforts to describe nations’ progress toward comprehensive tobacco control have hitherto taken little account of the role of cultural change to the meaning of smoking and the many ways in which it has become denormalised.

Methods: This paper identifies a diversity of generally undocumented yet pervasive markers of the “spoiled identity” of smoking, smokers and the tobacco industry, illustrated with examples from Australia, a nation with advanced tobacco control.
Results: We caution about some important negative consequences arising from the stigmatisation of smokers.
Conclusions: We recommend that schemes rating the comprehensiveness of national tobacco control should be supplemented by documentation of markers of this denormalisation.

Markers of the denormalisation of smoking and the tobacco industry -- Chapman and Freeman 17 (1): 25 -- Tobacco Control

The Results paragraph is misleading. The authors do not caution the tobacco control community against going too far in their campaign of deprecation and degradation.

Questions arising here include: Are smokers less likely to seek medical help due to public debates around whether they “deserve” medical treatments?62 Will they feel ashamed when doing so, adding to their stress and perhaps prognosis63 Are smokers unreasonably discriminated against in the workplace, even when they do not smoke indoors and put others at risk? (In 2005, the World Health Organisation announced that it would no longer hire smokers in any part of the organisation (http://www.who.int/employment/recruitment/en/).) Are sick smokers seeking legal redress unjustly vilified in popular consciousness as people entirely to blame for having taken up smoking as children and being unable to quit because of addiction?64 Do smoking prevalence surveys systematically under-report smoking because of smoker shame?65

We have listed and discussed a diverse range of markers of denormalisation that have largely unexplored status as interesting epiphenomena, but which collectively, we would argue combine to repeatedly make the overall cultural proposition that smoking and the industry behind it are decidedly negative. For the individual, an obvious escape from this negativity is to quit smoking, as hundreds of thousands do each year. For governments, this negativity foments a public climate that is highly receptive to tobacco control legislation, polices and programs. We would argue that there is a dynamic, synergistic relationship between formal tobacco control interventions and policies, falling smoking prevalence and the increasing range and growth of the markers we have listed. Arguably, the effect of these markers both stimulate cessation and in turn are themselves amplified by decreasing smoking prevalence as more and more citizens turn away from smoking and revile the tobacco industry’s role in trying to promote it.

So it isn't just "quit or die", it's "quit or suffer--physically, emotionally, and financially."