Words matter, particularly when they’re entwined with issues of identity. Labels have the capacity to erase the multi-faceted nature of our identities by reducing us to a single characteristic—something that overwhelmingly happens, unfortunately, to members of marginalized communities.
In the field of substance use disorder, among others, “person-centered language” has become a widely established principle in recent years. A 2021 paper—coauthored by Dr. Nora Volkow, director of the National Institute on Drug Abuse, itself the subject of calls for a name-change—supported this.
“The words we use to describe mental illnesses and substance use disorders,” it stated, “can impact the likelihood that people will seek help and the quality of the help they receive.”
Stigma is at the root of this reality—and why terms like “addict” or “substance abuser” are being rejected in favor of “person with substance use disorder,” or “person who uses drugs.”
Increasingly, these concerns are mirrored by debates in the tobacco harm reduction and tobacco control communities, where recent conferences and online discussions have featured calls to abandon the term “smoker.”
“I want to be referred to as a ‘person who smoked,’ because a cigarette has nothing to do with the person they should see.”
Tobacco harm reduction advocate and Filter contributor Skip Murray is a notable champion of this, and I asked her to explain.
“My life has been filled with labels that people have attached to me: fat, nerd, smoker, weirdo, emotional, autistic,” she told Filter. “Most of the time, their perception of me begins and ends with one of those labels.”
Such terms, according to Murray, work as a “smokescreen” to obfuscate meaningful and varied aspects of people’s characters.
“I don’t smoke anymore, but am still called a ‘smoker’ or ‘former smoker,’” she continued. “I want to be referred to as a ‘person who smoked,’ because a cigarette has nothing to do with the person they should see. I am strong, brave, a survivor. I have a big heart and am kind; I am smart, funny and giving. I spend my life trying to help people. To know me, that is what they need to see.”
It’s not in doubt that smoking has become a heavily stigmatized behavior. Adding to that, communities with the highest smoking rates—for example, people on low incomes, incarcerated people, LGBTQ people, Indigenous people, people with mental health diagnoses—are already marginalized before you factor in smoking.
Yet many in the wider field have not yet made this language change, and their reasons vary. “Smoker” is less clunky than “person who smokes,” of course, so some stick to it as a kind of shorthand, whether in speech or when writing an academic paper.
There are also elements in tobacco control who see the stigmatization of smoking, because of its harms, as a good thing—and enact policies that may reflect that—despite evidence that this kind of stigma carries harms of its own.
“I’m certainly not ashamed of smoking or being called a smoker.”
Then there’s the question of self-identification. Writer Josephine Bartosch, for instance, recently described starting to smoke again after a decade of abstinence, and “enjoying” her “newfound status as a smoker.”
“I’m certainly not ashamed of smoking or being called a smoker,” Bartosch told Filter.
“I think there’s an unfair attempt to stigmatize smokers in a way that there isn’t for those who drink alcohol or over-eat,” she added. “It seems unfair to me that adults who choose to smoke should be singled out with laws and restrictions—but as for the word ‘smoker,’ I’m happy to own the label and don’t think it’s offensive.”
There’s a distinction, of course, between calling yourself a “smoker”—just as people may self-describe as “addicts” in some contexts—and applying the term to someone else.
And others take a different line. David Breakspear, a peer mentor for United Kingdom charity Revolving Doors, has written on the importance of person-centered language to avoid dehumanizing people who are justice-involved.
“A ‘smoker’ is where you cure meat and fish!”
“I’m not suggesting that not using stigmatizing language is the answer to the ills of prison,” he told Filter. However, “not using it will help others to look at themselves through a more positive lens, and with any luck will change the way society views people in prison, because at the end of the day, people in prison are exactly that, people!”
On the “smoker” question, Breakspear replied, “as a person who smokes, and as someone who advocates for the use of person-first language, I prefer to be referred to as a person who smokes—a ‘smoker’ is where you cure meat and fish!”
When I asked people on social media if they’d prefer to be called a “smoker” or “person who smokes”—and whether it matters—I received a variety of responses.
Michael Redfearn said he preferred person-first language, and that “people shouldn’t be defined by a single activity.” James A, a tobacco harm advocate, agreed, calling the “smoker” term “elitist terminology used to promote hate by ivory tower tobacco control.”
In contrast, vaping advocate Robb Cabansag said, “I’m usually a stickler for precision of language, but honestly I don’t care. Smoker, vaper, runner, golfer … I don’t think it defines you, [it] just describes a thing you do.”
The comparison with “vaper,” which fewer people seem to object to, is interesting. Perhaps vaping is seen as less heavily stigmatized than smoking, although many would argue that’s not the case.
The Tobacco Control journal has no such doubts. An editorial published in early 2023 announced its new policy of replacing “smoker,” “vaper,” “tobacco user” and “other behavior-based labels.”
“Labeling people as smokers or vapers suggests the behavior is an immutable characteristic, an essential identity,” the authors wrote. “When the behavior is bound up in identity, it can become a target for overt discrimination.”
“The word conjures in the imagination someone careless and self-centered, an unwashed and stinky person.”
The philosopher Jean-Paul Sartre enjoyed smoking, and might have agreed that it was part of his identity. He famously said that “Man is nothing else … but the sum of his actions.”
But the connotation of smoking as an “immutable characteristic,” as the Tobacco Control authors put it, is something I don’t think Sartre would have agreed to. He might have called this “bad faith”—the false belief that because you smoke you will necessarily and inescapably continue to do so. The term “smoker,” in this light, would restrict a person’s freedom to reinvent themself. Sartre would say smoking was his choice, something mutable and not embedded into his essence.
“I treat my relationship with tobacco as a private matter,” David John, a Freudian psychoanalyst, told Filter. “A bit like my relationship with wine. Drinking wine doesn’t make me a ‘drinker’—or does it?”
John said that although he smokes cigarettes and a pipe, he doesn’t see himself as a “smoker,” although “my doctor might put ‘smoker’ on a form—they have a right to know.”
Nonetheless, “The word conjures in the imagination someone careless and self-centered, an unwashed and stinky person.”
It’s exactly that stigma that society has attached to the word—leaving little room for nuance or reinvention in the fixed, judgemental glare of a label—that’s prompting growing numbers to move away from its use.
Photograph by Castio T. Lauren via Flickr/Creative Commons 2.0
Correction, November 21: This article has been edited to correct the spelling of Michael Redfearn’s name.
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