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Nicotine addiction as a moral problem: Barriers to e-cigarette use for smoking cessation in two working-class areas in Northern England

Thirlway, Frances

Nicotine addiction as a moral problem: Barriers to e-cigarette use for smoking cessation in two working-class areas in Northern England Thumbnail


Authors

Frances Thirlway



Abstract

Tobacco use in high-income countries correlates with socio-economic disadvantage, but although switching to electronic cigarettes could be a safer alternative, little is known about barriers to use. Drawing on eighteen months of data collection in two areas of Northern England in 2017/18 including ethnography and interviews with 59 smokers and e-cigarette users, I show that concern about continued nicotine addiction either deterred working-class smokers from switching to e-cigarettes or dictated the conditions of their use. Research participants were unhappy about addiction both as loss of control experienced as moral failure and as neglect of financial responsibilities i.e. role performance failure in relation to family responsibilities, or what I call ‘thrift as care’. They reduced the moral burden of addiction by lowering nicotine content, rejecting pleasure and minimising expenditure. They chose the cheapest possible tobacco, switched from combusted tobacco to cheaper e-cigarettes and bought cheap e-cigarettes and liquids. For working-class smokers, minimising spend on what they perceive negatively as addiction may be a greater moral concern than reducing health risk. I conclude that ensuring that vaping is significantly cheaper than smoking may be key to addressing health inequalities linked to tobacco use.

Citation

Thirlway, F. (2019). Nicotine addiction as a moral problem: Barriers to e-cigarette use for smoking cessation in two working-class areas in Northern England. Social Science & Medicine, 238, Article 112498. https://doi.org/10.1016/j.socscimed.2019.112498

Journal Article Type Article
Acceptance Date Aug 16, 2019
Online Publication Date Aug 23, 2019
Publication Date Oct 31, 2019
Deposit Date Sep 3, 2019
Publicly Available Date Sep 3, 2019
Journal Social science and medicine
Print ISSN 0277-9536
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 238
Article Number 112498
DOI https://doi.org/10.1016/j.socscimed.2019.112498

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