It is important for clinicians to be aware that in some patients smoking stigma may complicate stigmas in other areas.

Researchers used the Internalized Stigma Smoking Inventory (ISSI) in 956 smokers with mental health diagnoses to assess the issue. They focused on three subscales:

• smoking self-stigma related to shame;

• felt stigma due to social isolation; and

• instances of discrimination.

Subjects most frequently reported discrimination overall. It was also highest in women, whites, and those with more education.

Self-stigma was experienced most in those who planned to quit. Felt stigma was most frequent in patients who said they experienced other stigmas tied to ethnicity and mental illness.

Investigators found ISSI to be a useful tool to quantify smoking stigma in multiple domains across a number of demographics. They urged practitioners to be particularly mindful of groups where tobacco use is not common.

Citation: Brown-Johnson C, Cataldo J, Orozco N, et al. Validity and reliability of the internalized stigma of smoking inventory: An exploration of shame, isolation, and discrimination in smokers with mental health diagnoses. Am J Addict. 2015;24:410 –418).