As members of a devalued group, it is not surprising that smokers experience stigmatization and discrimination. But it is not clear whether smokers react to these experiences by moving toward or away from their group membership and identity as smokers. In my NIH-funded research, guided by the Model of Stigma Induced Identity Threat, I examined in a series of experimental studies the question of whether stigmatization would cause smokers to experience emotional, behavioral, cognitive, and attitudinal effects that reduced or increased the likelihood that they would quit smoking.
In one study (Helweg-Larsen et al., 2020) we reminded smokers of their devalued status either by having them read a stigmatizing newspaper article or a control article (Experiment 1) or recall their experience with smoking discrimination or a control prompt (Experiment 2). Generally, we found that when smokers felt their identity was threatened by these prompts, they reacted with stress, rejection sensitivity, and interest in quitting.
We then examined what might happen when smokers are socially excluded but without any mention of it being related to their smoking status. In Helweg-Larsen and Tjitra (2021) we asked smokers to play an online Cyberball game, in which they were excluded or included in their ball-tossing game playing which they believed was with two non-smoking strangers. We found that exclusion led smokers to be more stressed and cognitively depleted but also to have fewer positive smoking cognitions, see themselves at greater health risk, feel more internalized stigma, and be more interested in quitting. In sum, ostracism led smokers toward cognitions, attitudes, and intentions associated with quitting smoking and thus leaving their devalued identity as smokers. Stigmatization is generally bad for health-related outcomes but in the case of smokers, coping with stigma can include leaving their group which is ultimately beneficial to their health. In addition, smokers’ interest in quitting might be a signal of their wish for re-inclusion in the dominant group (which is currently non-smokers).
Stigmatization is unpleasant and can to some extent be avoided by hiding one’s devalued status. In the Cyberball Game study (Helweg-Larsen & Tjitra, 2021) smokers were also randomly assigned to a concealed (the other players did not know of their smokers status) or revealed (the other players did know of their smoking status) condition. We found that concealment buffered against the effect of ostracism but did so imperfectly, in part because smokers assumed they were excluded due to their smoking status even when it was concealed.
Concerns about hiding one’s devalued status is particularly acute in evaluative situations. In one experiment (Helweg-Larsen et al, 2019) we showed the effects of outing smokers who might wish to be concealed. In the study, smokers participated in a mock job interview where their smoking status was either concealed or revealed to the interviewer. Results showed that smokers who were “outed” reacted with greater stress, cognitive depletion, self-exempting beliefs and were overall less interested in quitting, especially when they had a strong smoking identity (Helweg-Larsen et al., 2019).