From responsibility to stigma: A mediation analysis of the relationship between neoliberal ideology, moral views of addiction, and the stigmatization of pregnant smokers

This study examines the mediating role of the moral view of addiction in the relationship between neoliberal ideology and public stigma toward pregnant smokers. A total of 935 participants completed questionnaires assessing neoliberal ideology, moral views of addiction, and stigma toward smoking during pregnancy. Moral view of addiction significantly mediates the relationship between neoliberal ideology and the stigmatization of pregnant smokers. Individuals with stronger neoliberal values are more likely to view addiction as a moral failing, which is associated with derogatory cognitions (indirect effect: β = 0.15, p < 0.001), negative emotions and behaviors (β = 0.13, p < 0.001), and personal distress (β = 0.04, p < 0.001) toward pregnant smokers. These findings suggest that moral judgments about addiction might be shaped by neoliberal ideology and contribute to stigma. Addressing these ideological worldviews might be important for understanding stigma and improving healthcare engagement in pregnant smokers.