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I touched on this topic in my post on body shaming, and how it feels like shame is a tool being used by the public health community to “help” us develop better habits and be healthier.

The ones I already referenced are weight and smoking. You can’t really argue with the fact that among most adults smoking is viewed as reckless and bad. I see people hiding behind their places of work because they’re ashamed of being caught smoking by co-workers and employers. Some big hospitals have forbidden smoking during work hours, and I read about one place that is refusing to hire smokers. Smoking is a shameful habit. Smoking is an addiction and smokers are being treated as terrible addicts (the treatment and public view of addicts is a whole different issue which I have dealt with a number of times). Anyway, the campaign to make smoking bad succeeded. Smoking rates dropped significantly and public perception of smokers dropped. What used to be normal, and “cool” became abnormal, weird, and decidedly uncool.

What’s the problem? – you may be asking – smoking is bad. There is nothing good about it so isn’t it great that this campaign is working?

Yes and no. Obviously it is great that smoking rates are decreasing, but I really don’t like the way in which it was aided. This technique is once again being used with obesity, which is a much more difficult and subjective area. Not everyone who is overweight is unhealthy and measuring obesity is difficult because we all have such different body types and needs. But still this shame has perpetuated the public’s mentality. Many overweight people are ashamed of their size, and ironically it is often this shame that stops them from doing something about their weight (when there is a reason to) because they are embarrassed to be seen at the gym or ask for help.

Shame is a very dangerous tool to use in trying to fix a problem and it often backfires. How often have you heard of someone trying to shame an alcoholic parent for example into stopping because of what they’re doing to their family? How often does that work? A few times, sure. But generally, shaming a person makes them defensive, makes them less likely to listen, and more likely to continue in a negative behavior.

I would argue that shaming isn’t what reduced smoking so much as health reasons. Many ex-smokers I know quit for their health, usually because of a loved one breaking down about not wanting them to get sick. Shame makes people angry.

Maybe you disagree, maybe you think this shame thing has nothing to do with public health people and it just occurs because the behaviors are shameful. Well, what do you think of this ad to encourage men to get tested for HIV. It is suggesting that they have “no balls” if they are not getting tested. I think for a certain type of man to be told you have no balls is incredibly insulting and it is shaming to imply that by not getting tested they have no balls.

Shaming is a technique used to try and change behavior. It happens all the time. The fact that it has been institutionalized as a way to “fix” bad behaviors is even more disappointing to me. Let’s get people to fix “bad” behaviors through education about the risks and benefits of change not through shame. This is just another form of bullying that makes people think it’s okay to shame others for the things they do. Let’s try and be positive about these things, you will get better results. If you have a friend who smokes and you want him/her to quit, instead of lecturing him/her about the “dirty habit,” how about you talk to them about why they smoke, or if they plan on quitting, and how you can help?

Putting people down is not going to make them listen to you, it is just going to push them away. This is true for individuals and for institutions.

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