Los Angeles Times Book Prize Finalist
Winner of the Willie Lee Rose Prize
Winner of the PROSE Award in United States History
Hagley Prize in Business History Finalist
A Smithsonian Best History Book of the Year
“Vaping gets all the attention now, but Milov’s thorough study reminds us that smoking has always intersected with the government, for better or worse.”
—New York Times Book Review
From Jamestown to the Marlboro Man, tobacco has powered America’s economy and shaped some of its most enduring myths. The story of tobacco’s rise and fall may seem simple enough—a tale of science triumphing over corporate greed—but the truth is more complicated.
After the Great Depression, government officials and tobacco farmers worked hand in hand to ensure that regulation was used to promote tobacco rather than protect consumers. As evidence of the connection between cigarettes and cancer grew, scientists struggled to secure federal regulation in the name of public health. What turned the tide, Sarah Milov reveals, was a new kind of politics: a movement for nonsmokers’ rights. Activists took to the courts, the streets, city councils, and boardrooms to argue for smoke-free workplaces and allied with scientists to lobby elected officials. The Cigarette puts politics back at the heart of tobacco’s rise and fall, dramatizing the battles over corporate influence, individual choice, government regulation, and science.
“A nuanced and ultimately devastating indictment of government complicity with the worst excesses of American capitalism.”
“An impressive work of scholarship evincing years of spadework…A well-told story.”
—Wall Street Journal
“If you want to know what the smoke-filled rooms of midcentury America were really like, this is the book to read.”
—Los Angeles Review of Books
The 1966 edition of the leading medical textbook states that pregnant women can safely smoke half a pack of cigarettes a day. Yet today, women who smoke during pregnancy are among the most vilified figures in public health campaigns. Laury Oaks argues this shift is not due solely to medical findings indicating that cigarette smoking may harm the fetus. Also responsible are a variety of social factors that converged more than a decade ago to construct the demonized category of the “pregnant smoker.”
This book charts the emergence of smoking during pregnancy as a public health concern and social problem. Oaks looks at the emphasis public health educators place on individual responsibility, the current legal and social assertion of fetal personhood, the changing expectations of pregnant and prepregnant women, and the advent of antismoking campaigns. She explores how public health educators discuss “the problem” with one another, how they communicate with pregnant smokers, and how these women themselves understand the “risk” of fetal harm. Finally, Oaks discusses the various meanings of “objective” statistics on the effects of smoking on the fetus, exploring the significance of cultural context in assessing the relative importance of those numbers. She argues that rather than bombarding pregnant women with statistics, health educators should consider the daily lives of these women and their socioeconomic status to understand why some women choose to smoke during pregnancy. Without downplaying the seriousness of the health risks that smoking poses to women and their babies, the book supports new efforts that challenge the moral policing of pregnant smokers.
How do smokers evaluate evidence that smoking harms health? Some evidence suggests that smokers overestimate health risks from smoking. This book challenges this conclusion. The authors find that smokers tend to be overly optimistic about their longevity and future health if they quit later in life.
Older adults' decisions to quit smoking require personal experience with the serious health impacts associated with smoking. Smokers over fifty revise their risk perceptions only after experiencing a major health shock--such as a heart attack. But less serious symptoms, such as shortness of breath, do not cause changes in perceptions. Waiting for such a jolt to occur is imprudent.
The authors show that well-crafted messages about how smoking affects quality of life can greatly affect current perceptions of smoking risks. If smokers are informed of long-term consequences of a disease, and if they are told that quitting can indeed come too late, they are able to evaluate the risks of smoking more accurately, and act accordingly.
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