Marketing Health : Smoking and the Discourse of Public Health in Britain, 1945-2000

The post war history of public health and the role of smoking within that history epitomises the tensions which surround taking health to the public. Public health history has largely concentrated on the nineteenth century sanitary period or on the years before the Second World War, often focussing on the environmental advances, or on the professional and occupational history of public health as an activity. This book has a different focus: it deals with the change in the outlook of public health post war. From a focus on services, vaccination, and dealing with health issues at the local level, public health had developed new discourse. Centring on chronic disease, it became concerned with the concept of "risk" and targeted individual behaviour. The mass media and centralised campaigning directed at the whole population replaced local campaigns, and politicians changed their mind about speaking directly to the public on health matters. Their early worries about the 'nanny state' gave place to a desire to inculcate new norms of behaviour, and it was debated how change was to be achieved.Identifying debates between those believing in "systematic gradualism" and those who advocated a more coercive approach, Virginia Berridge uses smoking as a model. Such debates brought into play tensions over the relationships between public health and industrial interests. Health campaigning by new style pressure groups like ASH, which were part state funded, was an important motive force behind the change. In the 1980s and 1990s, public health changed again. Passive smoking and HIV/AIDS brought environmental concerns back into public health, which had disappeared after the 1950s. The "rise of addiction" for smoking demonstrated the power of pharmaceutical interests to define a new "pharmaceutical public health" in which treatment and "magic bullets" were also tactics for prevention. In the early 21st century, public health was play to complex tensions and conflicting impetuses. This book shows that those tensions were nothing new and outlines their development over the last half century. The post war history of public health and the role of smoking within that history epitomises the tensions which surround taking health to the public. Public health history has largely concentrated on the nineteenth century sanitary period or on the years before the Second World War, often focussing on the environmental advances, or on the professional and occupational history of public health as an activity. This book has a different it deals with the change in the outlook of public health post war. From a focus on services, vaccination, and dealing with health issues at the local level, public health had developed new discourse. Centring on chronic disease, it became concerned with the concept of "risk" and targeted individual behaviour. The mass media and centralised campaigning directed at the whole population replaced local campaigns, and politicians changed their mind about speaking directly to the public on health matters. Their early worries about the 'nanny state' gave place to a desire to inculcate new norms of behaviour, and it was debated how change was to be achieved. Identifying debates between those believing in "systematic gradualism" and those who advocated a more coercive approach, Virginia Berridge uses smoking as a model. Such debates brought into play tensions over the relationships between public health and industrial interests. Health campaigning by new style pressure groups like ASH, which were part state funded, was an important motive force behind the change. In the 1980s and 1990s, public health changed again. Passive smoking and HIV/AIDS brought environmental concerns back into public health, which had disappeared after the 1950s. The "rise of addiction" for smoking demonstrated the power of pharmaceutical interests to define a new "pharmaceutical public health" in which treatment and "magic bullets" were also tactics for prevention. In the early 21st century, public health was play to complex tensions and conflicting impetuses. This book shows that those tensions were nothing new and outlines their development over the last half century. The post war history of public health and the role of smoking within that history epitomises the tensions which surround taking health to the public. Public health history has largely concentrated on the nineteenth century sanitary period or on the years before the Second World War, often focussing on the environmental advances, or on the professional and occupational history of public health as an activity. This book has a different focus: it deals with the change in the outlook of public health post war. From a focus on services, vaccination, and dealing with health issues at the local level, public health had developed new discourse. Centring on chronic disease, it became concerned with the concept of'risk'and targeted individual behaviour. The mass media and centralised campaigning directed at the whole population replaced local campaigns, and politicians changed their mind about speaking directly to the public on health matters. Their early worries about the'nanny state'gave place to a desire to inculcate new norms of behaviour, and it was debated how change was to be achieved. Identifying debates between those believing in'systematic gradualism'and those who advocated a more coercive approach, Virginia Berridge uses smoking as a model. Such debates brought into play tensions over the relationships between public health and industrial interests. Health campaigning by new style pressure groups like ASH, which were part state funded, was an important motive force behind the change. In the 1980s and 1990s, public health changed again. Passive smoking and HIV/AIDS brought environmental concerns back into public health, which had disappeared after the 1950s. The'rise of addiction'for smoking demonstrated the power of pharmaceutical interests to define a new'pharmaceutical public health'in which treatment and'magic bullets'were also tactics for prevention. In the early 21st century, public health was play to complex tensions and conflicting impetuses. This book shows that those tensions were nothing new and outlines their development over the last half century. The post war history of public health and the role of smoking within that history epitomises the tensions which surround taking health to the public. Public health history has largely concentrated on the nineteenth century sanitary period or on the years before the Second World War, often focussing on the environmental advances, or on the professional and occupational history of public health as an activity. This book has a different focus: it deals with the change in the outlook of public health post war. From a focus on services, vaccination, and dealing with health issues at the local level, public health had developed new discourse. Centring on chronic disease, it became concerned with the concept of 'risk' and targeted individual behaviour. The mass media and centralised campaigning directed at the whole population replaced local campaigns, and politicians changed their mind about speaking directly to the public on health matters. Their early worries about the 'nanny state' gave place to a desire to inculcate new norms of behaviour, and it was debated how change was to be achieved. Identifying debates between those believing in 'systematic gradualism' and those who advocated a more coercive approach, Virginia Berridge uses smoking as a model. Such debates brought into play tensions over the relationships between public health and industrial interests. Health campaigning by new style pressure groups like ASH, which were part state funded, was an important motive force behind the change. In the 1980s and 1990s, public health change again. Passive smoking and HIV/AIDS brought environmental concerns back into public health, which had disappeared after the 1950s. The 'rise of addiction' for smoking demonstrated the power of pharmaceutical interests to define a new 'pharmaceutical public health' in which treatment and 'magic bullets' were also tactics for prevention Contents......Page 10 List of Illustrations......Page 12 List of Abbreviations......Page 14 Introduction. Marketing Health: Smoking and the Discourse of Public Health, 1945–2000......Page 18 1. Public Health in the 1950s: The Watershed of Smoking and Lung Cancer......Page 40 2. Medicine and the Media: Marketing Public Health in the 1960s......Page 69 3. Systematic Gradualism: Harm Reduction, Public Health, and the Industry, 1950s–1971......Page 98 4. Technical Public Health: The 1971 Cross-Government Enquiry and the Rise of Economics......Page 122 5. Expert Committees and Regulation in the 1970s......Page 153 6. The Rise of Health Activism in the 1970s: The Health Pressure Group......Page 182 7. The New Public Health Package......Page 206 8. Environment and Infectious Disease in the 1980s: From Passive Smoking to AIDS......Page 229 9. Medicating the Underclass? Pharmaceutical Public Health and the Discovery of Addiction......Page 262 Conclusion......Page 300 Appendix: Who Has Smoked and How Much......Page 306 Bibliography......Page 309 A......Page 332 B......Page 334 C......Page 335 D......Page 337 E......Page 339 G......Page 340 H......Page 341 I......Page 343 J......Page 344 L......Page 345 M......Page 346 N......Page 348 P......Page 349 R......Page 351 S......Page 352 T......Page 355 W......Page 358 Y......Page 359 No Further Information Has Been Provided For This Title. Introduction. Marketing Health: Smoking And The Discourse Of Public Health, 1945-2000 -- Public Health In The 1950s: The Watershed Of Smoking And Lung Cancer -- Medicine And The Media: Marketing Public Health In The 1960s -- Systematic Gradualism: Harm Reduction, Public Health, And The Industry, 1950s-1971 -- Technical Public Health: The 1971 Cross-government Enquiry And The Rise Of Economics -- Expert Committees And Regulation In The 1970s -- The Rise Of Health Activism In The 1970s: The Health Pressure Group -- The New Public Health Package -- Environment And Infectious Disease In The 1980s: From Passive Smoking To Aids -- Medicating The Underclass? Pharmaceutical Public Health And The Discovery Of Addiction -- Conclusion -- Who Has Smoked And How Much. Virginia Berridge. Includes Bibliographical References And Index. The author examines the way in which public health policy has changed and developed since the Second World War. It explains how public health began to focus on 'lifestyle' diseases, and looks at the debates which took place along the way, using smoking as a model