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Step free of shame and stigma

Dr_Hays
Mayo Clinic
11 7 291

Shame is distressful feeling related to negative thoughts or perceived evaluations of ourselves – a sense that ‘I am bad’.  It is distinguished from guilt, which is a remorse focused upon an action – a sense that I did something wrong.  When it comes to making changes like stopping smoking, that may require multiple tries, and learning from past efforts that were not fully successful, shameful thoughts like ‘what’s wrong with me’, can be an obstacle to success rather than an effective motivation for change.  

Shame about tobacco use has increased over the past 20 years as smokers feel more ‘stigmatized’.   This feeling is understandable.  Rules about smoke free indoor environments, tax increases intended to promote quitting, and public health messages about the tragic health consequences from tobacco can evoke the feeling among smokers of ‘being singled out’.    People can understandably become defensive, defiant, and isolated in response to feeling ‘stigmatized’, and this can decrease the desire and intention to stop smoking.

An additional complication related to shame and smoking has to do with the nature of tobacco addiction.  Tobacco addiction can be seen in part as the hijacking of the unconscious, habitual, automatic part of the brain.  When a person is in a usual smoking situation, like the car, with other smokers, a break between jobs, or a stressful situation, the urge and physical response of reaching for a cigarette can be triggered automatically.   Planning to manage these situations with forethought based upon self-knowledge and past experience of trial and error is much more likely to lead to success, rather than a shame based reaction such as ‘what’s wrong with me’ or ‘why do I keep doing this’.

Stopping smoking can be very difficult.  How we evaluate that challenge, can add or lessen distress and discouragement.   Looking at past attempts as educational, rather than as ‘failures’, and perceiving yourself with self-compassion rather than blame can pave the way for success.

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About the Author
An expert in tobacco use and dependence, Dr. Hays has authored and co-authored over 70 peer-reviewed scholarly articles and book chapters on various aspects tobacco dependence and its treatment. Since joining the Nicotine Dependence Center in 1992, he and its staff have treated more than 50,000 patients for tobacco dependence.