Can ‘justified disapproval’ be separated from addiction stigma? An empirical focus is required

Abstract

Stigma is largely recognized as a harmful practice of social devaluation and discrimination, yet some scholars still advance arguments that stigma also serves an important disincentivizing force toward addictive behaviors. Whilst others counter that stigma is a fundamentally harmful process, a more nuanced call has been made for ‘justified disapproval’ as a beneficial normative force to be separated from addiction stigma. The legitimacy of such a claim requires empirical support which has been lacking thus far. We review evidence in the domains of social norms, stigma, addiction and behavioral sciences as a starting point for an empirically focused evaluation of the possibility of ‘justified disapproval’ as a legitimate positive force. We note that whilst normative influences, emotions and addiction-relevant appraisals affect such behaviors under certain conditions, there are important questions regarding whether these can be harnessed without invoking the known and pervasive effects of stigma. Rather, we propose that efforts to curb addiction-related behaviors via normative influences are likely to fail or backfire. In the absence of empirical evidence to support the use of normative ‘disapproval’ strategies, alternative approaches should be pursued, particularly those which address the broader socio-cultural and structural drivers of addiction problems.