How will e-cigarettes affect health inequalities? Applying Bourdieu to smoking and cessation

TY - JOUR

T1 - How will e-cigarettes affect health inequalities? Applying Bourdieu to smoking and cessation

AU - Thirlway, Frances

N1 - © 2018 The Author. This is an author-produced version of a paper accepted for publication. Uploaded with permission of the publisher/copyright holder. Further copying may not be permitted; contact the publisher for details

PY - 2018/1/27

Y1 - 2018/1/27

N2 - This paper uses the work of Bourdieu to theorise smoking and cessation through a class lens, showing that the struggle for distinction created the social gradient in smoking, with smoking stigma operating as a proxy for class stigma. This led to increased policy focus on the health of bystanders and children and later also to concerns about electronic cigarettes. Bourdieu’s concept of habitus is deployed to argue that the e-cigarette helps middle-class smokers resolve smoking as a symptom of cleft habitus associated with social mobility or particular subcultures. E-cigarette use is also compatible with family responsibility and sociable hedonism, aspects of working-class habitus which map to the ‘practical family quitter’ and the ‘recreational user’ respectively. The effectiveness of class stigma in changing health behaviours is contested, as is the usefulness of youth as a category of analysis and hence the relevance of concerns about young people’s e-cigarette use outside a class framework of smoking and cessation. With regard to health inequalities, whilst middle-class smokers have in class disgust a stronger incentive to quit than working-class smokers, there is potential for tobacco control to tap into a working-class ethos of family care and responsibility.

AB - This paper uses the work of Bourdieu to theorise smoking and cessation through a class lens, showing that the struggle for distinction created the social gradient in smoking, with smoking stigma operating as a proxy for class stigma. This led to increased policy focus on the health of bystanders and children and later also to concerns about electronic cigarettes. Bourdieu’s concept of habitus is deployed to argue that the e-cigarette helps middle-class smokers resolve smoking as a symptom of cleft habitus associated with social mobility or particular subcultures. E-cigarette use is also compatible with family responsibility and sociable hedonism, aspects of working-class habitus which map to the ‘practical family quitter’ and the ‘recreational user’ respectively. The effectiveness of class stigma in changing health behaviours is contested, as is the usefulness of youth as a category of analysis and hence the relevance of concerns about young people’s e-cigarette use outside a class framework of smoking and cessation. With regard to health inequalities, whilst middle-class smokers have in class disgust a stronger incentive to quit than working-class smokers, there is potential for tobacco control to tap into a working-class ethos of family care and responsibility.

KW - smoking cessation, e-cigarettes, Bourdieu, distinction, class, habitus, stigma

U2 - 10.1016/j.drugpo.2018.01.009

DO - 10.1016/j.drugpo.2018.01.009

M3 - Article

SN - 0955-3959

VL - 54

SP - 99

EP - 104

JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

IS - C

ER -