What is it about?
The World Health Organisation recognises that several marginalised groups are being left behind by tobacco control programmes worldwide. This paper looks at three such groups: Indigenous people, people with mental health conditions and members of the rainbow communities (lesbian, gay, bisexual, transgendered, intersex and others who don't identify with heterosexual male and female identities). Common across all three groups were a lack of smoking prevalence information, and a general neglect of these groups by those in power. Being stigmatised appears to be an important potential driver of higher smoking rates.
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Why is it important?
Finding that three very different groups are similarly neglected by global tobacco control efforts reveals that the higher smoking rates in these groups are not due to characteristics of the groups. This paper explains how a utilitarian mono-cultural approach works to exclude people who are different from the people in power. Equitable reduction of harms related to smoking tobacco across all peoples will not be achieved until diverse groups are represented at a leadership and intervention development level.
Perspectives
I have worked for almost 30 years to reduce smoking-related harms among Māori - the indigenous people of New Zealand. The colonisation of New Zealand (one of a number of countries Britain took over) established Anglo-Western beliefs and institutions and culture as dominant. The English settlers, and the constant inflow of new English settlers, dominate every institution. Everything is structured for their benefit - the majority. If you are different, if you belong to a minority group or if you are seen as a threat to the people enjoying their dominance - the pathway to succeed in anything (health, career, the arts) is not laid out for you. If you find a door, it will more often than not, be closed on you. If you get entry, you are always just tolerated. If you try to change things for outsiders, you'll find yourself once again on the outside. Higher smoking rates among marginalised minority groups are indicative of both the greater stress of being discriminated against and excluded, and the lack of culturally effective support to stop smoking. It is simple: if you are part of the in-group you get to sit at the table and eat pie. If you are part of an out-group you will have to scramble for the crumbs they flick from their table. Ultimately, high rates of smoking among the out-groups, the threats, the people excess to requirements, serves the dominant group. I was involved in the international meetings that contributed to the writing of the Framework Convention on Tobacco Control (FCTC). The FCTC has been corrupted. It is not honouring any of the principles, articles or clauses that promised to honour cultural diversity. It rejects science. It has become a barrier to the reduction of smoking-related disease and deaths especially among non-Anglo-Western and marginalised groups.
Marewa Glover
Centre of Research Excellence: Sovereignty & Smoking
Read the Original
This page is a summary of: Tobacco smoking in three “left behind” subgroups: indigenous, the rainbow community and people with mental health conditions, Drugs and Alcohol Today, July 2020, Emerald,
DOI: 10.1108/dat-02-2020-0004.
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