The word “smoker” is a disparaging term, like “addict” or “alcoholic” and we should stop using it.

It is no longer acceptable to talk of “the disabled”.as if they are one homogenous group of, perhaps, rather sub-human beings. Instead, we use the term “People With Disabilities” or “PWD”. This is called “person-first” usage, and it identifies the humanity of the person before describing their condition.

It is easy to dismiss this idea as being an example of “woke” culture, the domain of the “social justice warrior”, but in fact words are important. The use of a label such as “smoker”, “addict” or “illegal” divides people up into “us” and “them”. It is a slippery slope toward calling certain groups or tribes “vermin” or “cockroaches”, labels that have been used to justify genocides.

A recent publication”Time to quit using the word “smoker” raises some additional points.:

There is no scientific consensus as to the definition of a “smoker”. Is someone who has cut down to two cigarettes a day still a “smoker”? Is it a matter of self-identification, so that someone who only smokes “borrowed” cigarettes at a party can define themself as a “non-smoker”?

In the 1980s advocates began to avoid using dehumanizing and exclusionary language such as “drug addict” or “prostitute”, and a harm reduction approach to drug use and to sex workers became a socially-acceptable norm. In tobacco control, we have stuck with the term “smoker” and tobacco harm reduction using safer nicotine products is not accepted in most of the world. Is this a correlation, or is it cause and effect? Does it mean that, despite tobacco use disorder being classified as a disease in DSM-5, we still think of it as a habit?

Why should we care about people who smoke? Many people think: “They chose to smoke, knew the risks and could quit if they really wanted to”. The subtext of this is that if they keep on smoking, they deserve to die. But none of these statements are true.

The CDC lists 12 cancers and 20 other diseases that are caused by smoking. How many people who smoke know all these risks? How many understand that smoking can also lead to decades of disability, as a cardiac or respiratory cripple, as someone who needs a wheelchair after an amputation or who is unable to speak after a stroke? How many know that 2/3 of smokers will die, on average 10 years too early, from smoking-related diseases, missing out on their “golden years” when they could be with their grandchildren or on the golf course?

Most smokers started to smoke as teenagers. Nearly 90% of adults who smoke tried smoking by age 18, but the human brain is not fully mature until 25. Young teens have spent their lifetime being controlled by their parents, being told when to get up, when to go to bed, what to eat, when their hair is too long or their skirts too short. When they start to earn money, to have a place of their own, and to make new friends, they rebel against these restrictions. Adolescence is intended as a time to explore boundaries and take risks. It is hard to blame a teen who decides to try smoking or vaping, and assumes that there are effective ways to quit later in life.

Quitting is really important. If people quit smoking in their 40s, they avoid almost all of the risks of smoking. But our standard smoking cessation methods are very ineffective:

If 100 people try to quit:

Cold turkey: 4 quit, 96 still smoke

NRT: 7 quit, 93 still smoke

Drugs: 10 quit, 90 still smoke

E-cigarettes: 18 quit, 82 still smoke

Many people who smoke would like to quit and have tried but have not succeeded. They continue to smoke cigarettes because we have failed to offer them realistic alternatives.

We should care more about people who smoke. We should begin by calling them “people who smoke”, not labelling them as”smokers”.

We should realize that many of them are dependent on nicotine, NOT “addicted to smoking”, and that the appropriate response is to offer them easy access to safer, affordable, and enjoyable alternatives to cigarettes.