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AJPH First Look, published online ahead of print Nov 29, 2005
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January 2006, Vol 96, No. 1 | American Journal of Public Health 47-50
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.071886

HEALTH POLICY AND ETHICS

Tobacco Control, Stigma, and Public Health: Rethinking the Relations

Ronald Bayer, PhD and Jennifer Stuber, PhD

Ronald Bayer is with the Center for the History and Ethics of Public Health, Department of Sociomedical Sciences, Mailman School of Public Health, New York, NY. Jennifer Stuber is a Robert Wood Johnson Health and Society Scholar at Columbia University, New York.

Correspondence: Requests for reprints should be sent to Jennifer Stuber, 420 W 118th Street, 8th Floor, Mail Code 3355, New York, NY 10027 (e-mail: js2642{at}columbia.edu).

The AIDS epidemic has borne witness to the terrible burdens imposed by stigmatization and to the way in which marginalization could subvert the goals of HIV prevention. Out of that experience, and propelled by the linkage of public health and human rights, came the commonplace assertion that stigmatization was a retrograde force.

Yet, strikingly, the antitobacco movement has fostered a social transformation that involves the stigmatization of smokers. Does this transformation represent a troubling outcome of efforts to limit tobacco use and its associated morbidity and mortality; an ineffective, counterproductive, and moralizing approach that leads to a dead end; or a signal of public health achievement? If the latter is the case, are there unacknowledged costs?




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