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“If You Smoke, You Stink.” Denormalisation Strategies for the Improvement of Health-Related Behaviours: The Case of Tobacco

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Ethics in Public Health and Health Policy

Part of the book series: Public Health Ethics Analysis ((PHES,volume 1))

Abstract

Denormalisation has emerged as a possible strategy to influence health-related behaviours, particularly in the context of anti-smoking initiatives. Denormalisation strategies aim to influence social norms surrounding the behaviour in question, by making the behaviour less visible and reducing its social acceptability, so as to motivate individuals to change behaviours and to strengthen public support for other public health measures and interventions. Focusing on anti-smoking efforts, this chapter assesses denormalisation strategies with respect to two concerns. First, denormalisation strategies may contribute to the stigmatisation of smokers. Second, denormalisation strategies may add to existing burdens among disadvantaged groups. These concerns point to highly problematic and potentially counterproductive effects of denormalisation strategies. However, two approaches – social norms marketing and tobacco industry denormalisation – could provide more constructive and less problematic applications of the denormalisation strategy and may therefore have a role to play in the pursuit of public health.

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Notes

  1. 1.

    This strategy has been discussed primarily in the smoking context. However, similar goals may be pursued with respect to other health-related behaviours. For example, a policy document published by the UK Department of Health calls for a “cultural shift in public attitudes towards the type and amount of food eaten and the importance of regular physical activity” (Department of Health 2004, p. x). The focus of this chapter will be on denormalisation in the context of tobacco use; however, many of the concerns raised in this paper may also apply to denormalisation strategies used with respect to other health-related behaviours.

  2. 2.

    This approach is also part of the idea of “libertarian paternalism”, which has received much attention over the past few years. Sunstein and Thaler suggest that this insight can be exploited to reduce energy consumption: Informing customers on their utilities bills that their neighbours are using less energy than them can motivate them to reduce their energy usage (Sunstein and Thaler 2008).

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Acknowledgments

I would like to thank Garrath Williams, the editors of this volume and an anonymous referee for their helpful comments and suggestions.

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Authors and Affiliations

  1. Department of Philosophy and Institute for Health and Social Policy, McGill University, Montreal, Canada

    Kristin Voigt

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  1. Kristin Voigt
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Correspondence to Kristin Voigt .

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  1. Carl-Neuberg-Str. 1, Hannover, 30625, Niedersachsen, Germany

    Daniel Strech

  2. Carl-Neuberg-Str. 1, Hannover, 30625, Niedersachsen, Germany

    Irene Hirschberg

  3. Ludwig-Maximlians-University Munchen, Lessingstr 2, Munchen, 80336, Germany

    Georg Marckmann

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Voigt, K. (2013). “If You Smoke, You Stink.” Denormalisation Strategies for the Improvement of Health-Related Behaviours: The Case of Tobacco. In: Strech, D., Hirschberg, I., Marckmann, G. (eds) Ethics in Public Health and Health Policy. Public Health Ethics Analysis, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6374-6_4

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