Tobacco Documents Online

271 March 5, 1982 PETER L. BERGER 4 Worthington Road Brookline, Mass. 02146 Tel. (617) 738-5703 I am a sociologist, currently a University Professor at Boston University. The following is a personal statement, which does not necessarily represent the views of any institution with which I am affiliated. (A brief vita is enclosed.) My attention was first drawn to H.R. 4957 and S. 1929 by an article in the New York Times on January 30, 1982; i subsequently obtained the texts of the two bills. The latter, in my opinion, constitute a further step in a development that has, for some time now, interested me as a sociologist and disturbed me as a citizen; that is, the growing militancy of the anti-smoking movement and its attempts.to control or limit smoking activity. I have no competence with regard to the medical questions at issue. However, I do claim competence with regard to the broader social and cultural context of this development, and it seems to me that it raises some rather fundamental questions about the scope and purposes of democratic governance on which any citizen has the right to claim competence. What first interested me in this matter was the aggressiveness with which anti-smoking activities carried on their campaign. It annoyed me as a smoker (though perhaps I should say that I smoke cigars and pipes, not cigarettes, which are the major targets of the anti-smoking groups). No one likes

272 to be depicted as a victim of debilitating vice or awa'_king threat to public health, and the segregation ir.creasingly imposed on smokers in various public places is frequently demeaning. What also intrigued me, though, was why some anti-smokers were so aggressive about this matter. I could not quite believe that they were all that concerned about me (and other practitioners of this custom). After all, a lot of other things that I and others do are also claimed to be bad for health, yet no comparable furor surrounds them -- and I began to suspect that more complicated motives and interests were involved. I expressed these misgivings in the attached article, "Gilgamesh on the Washington Shuttle," published in Worldview magazine in November 1977. While this matter has not been a major focus of my pro- fessional activities (which, in recent years, have centered on the problems of Third World development), I have maintained an interest in the issue of smoking, contemporary culture and public policy. In the summer of 1979, for example, I attended the Fourth World Conference on Smoking and Health, held in Stockho Lm under the auspices of the World Health Organization (no doubt an appropriate location considering that the Scandinavian countries have the most stringent anti-smoking policies anywhere). I sub- sequently served as consultant to a study of the anti-smoking movement in Britain and the United States conducted, by Professor Aaron Wildavsky of the University of California at' Berkeley. In 1981 I gave a presentation at the Conference on Consumer Policy at the Wharton School in Pennsylvania. (This - 2 - 2' dealt generally with the evaluati presentation only mentioned smoki smoking issue in a wider context tion.) Consequently, I have a gc the various arguments made in the As to the bills under doubts whatever about the sincer what concerns me is the manner : enacted, could be used by the ant that this would be another step i matizing and even criminalizing stigmatized as a disease; then segregated; finally, smoking wc behavior, to be eventually eradi, the most private locations (to t consenting adults in the privacy concerns me even more is what tt role of government (in this case, lives. It seems to me that thos this legislative proposal should matters -- the general cultural c ment power. The General Cultural Context The campaign against phenomenon; rather, it must be a

273 0 dealt generally with the evaluation of risks in everyday life; my presentation only mentioned smoking in passing, but it placed the smoking issue in a wider context of the quest for risk reduc- tion.) Consequently, I have a good measure of familiarity with the various arguments made in the course of this controversy. As to the bills under consideration here, I have no doubts whatever about the sincere intentions of the sponsors. What concerns me is the manner in which such legislation, if enacted, could be used by the anti-smoking forces. My concern is that this would be another step in a long-term campaign of stig- matizing and even criminalizing smoking. First, smoking is stigmatized as a disease; then, smokers are physically segregated; finally, smoking would be viewed as abnormal behavior, to be eventually eradicated or suppressed in all but the most private locations (to be engaged in, if at all, by consenting adults in the privacy of their bedrooms). 3ut what concerns me even more is what this development says about the role of government (in this case, the Federal government) in our lives. It seems to me that those who favor or are considering this legislative proposal should give seYious thought to two matters -- the general cultural context and the issue of govern- ment power. . The General Cultural Context The campaign against smoking is not an isolated phenomeaon; rather, it must be seen in a much wider context of i - 3 -

27 cultural and social developments in this society. Specificallv, ~ it is part of a pervasive quest for security on the part of large numbers of Americans (who, incidentally, share this trait with people in other Western societies). There is a mind-set in this that cannot be unfairly described as institutionalized hypo- chondria: Life is full of hidden dangers and risks, many of them imposed on the innocent citizenry by rapacious forces beyond- their control; this is intolerable; citizens must, therefore,` " organize to combat these evil forces and, wherever possible," enlist government in this battle. The obverse of this vision of an infinitely dangerous environment is a utopia in which dangers and risks are reduced to a minimum if not eliminated altcgether. The combination of these two themes, one hypochondri- acal and the other utopian, makes for a curious ambivalence of timidity and aggression. On the one hand, people with this mind-set see themselves constantly surrounded by terrible perils, many of them deliberately caused or exploited by forces perceived as enemies; on the other hand, the same people beccme increasingly combative, aggressive and single-minded in the pursuit of their own goals. One can find this constellation of attitudes in a con- ' siderable variety of public issues. But, logically enough, health is a favored focus of these concerns. It is also logical (at least in a pyZ chological sense) that individuals greatly concerned about their own health should be attracted to the anti-smoking movement. Now, I am not saying that it - 4 - _:rational to be concerned with he _.n the mind-set at issue, there ie ___e, by its very nature, is risk~ stvle of passivity would eradicate _= well, however, the greatest ris ..,_eover, the ultimate human risk -annot be avoided. Thus, the uto- "_nally denies the root fact of -=titudes are prominent in the ant ::e latter's literature, one gets t -;=cpped smoking, we would live for recurring phrase of "unnecessar "smoking epidemic") -- a very 3_nce, in the end, death is the finj I do not want to be misun c sayina that everfone who favor =?a.ast smoking is motivated by sucr `•`•at these are themes in the ideolo -ent• I'm also saying that these th -~ci•riduals and to society as a whol = 3= dwell on the fearful dangers b =-'Oid risks of any kind, which is nc =1ce of the challenges of life. There is another very impo = e general context of this issue: --°ferences bcth in the general th, - 7 -

275 irrational to be concerned with health; of course it's not. But in the mind-set at issue, there is a tendency to deny that human life, by its very nature, is risky, and to assume that a life- style of passivity would eradicate all risks. As Wildavsky put it well, however, the greatest risk is to take no risks at all. moreover, the ultimate human risk is death, and that, alas, cannot be avoided. Thus, the utopia of a risk-free existence finally denies the root fact of our mortality. All these attitudes are prominent in the anti-smoking movement. Reading the latter's literature, one gets the impression that, if we only stopped smoking, we would live forever. For example, there is the recurring phrase of "unnecessary deaths" (allegedly caused by the "smoking epidemic") -- a ve rl curious and revealing phrase since, in the end, death is the final necessity for all of us. I do not want to be misunderstood on this point. I'm not saying that everyone who favors public policies directed against smoking is motivated by such considerations. I am saying that these are themes in the ideology of the anti-smoking -move- ment. I'm also saying that these themes are debilitating both to individuals and to society as a whole. Individuals and sccieties that dwell on the fearful dangers besetting them will ter.d to avoid risks of any kind, which is not a healthy posture in the face of the challenges of life. There is another very important point to be made about the general context of this issue: There are significant class differences both in the general themes just described and - 7 -

276 specifically in the area of smoking. Lower-income people are more likely to smoke more than upper-income people; conversely, the anti-smoking movement (as are other movements concerned with health and risk reduction of all sorts) is overwhelmingly upper-income in its constituency. Putting this in more sociological terms, the anti-smoking campaign is an initiative coming from the upper-middle-class, while its putative beneficiaries are concentrated in the working class. Put in non-sociological terms, this is but another case of evangelism, in which the better-off classes in our society are trying to impose their own lifestyles on those who are less well off. There is a long history of this, going all the way back to the early 19th century. The most ambitious case, of course, was Prohibition -- and the long Temperance Movement that preceded it. Here too, well-meaning middle-class people were trying to convert and eventually coerce their social "inferiors". :n allusion to George Bernard Shaw's famous play, we might call this kind of cultural imperialism the "Major Barbara complex". Needless to say, working-class people resent this sort of meddling, and they resist it. The same tensions between well-meaning yet aggressive missionaries of a "nice" lifestyle on the one hand and those who are supposed to be the beneficiaries of these efforts on the other hand can be found in the contem- porary smoking controversy. It also goes without saying that the upper-middle-class missionaries have greater resources at their disposal in this cultural welfare -- not only resources of money - 6 - 277 and power, but of education that su claims to "know better". The bottoi always "We know what is best for yoc right to tell you how you should 1ii the response of working-class pec interventionism tends to be quite unprintable). Cultural themes are typi: interests of one sort or another. Z thundering against the vested intere but in time it was quite correct interests". Similarly, the anti- attacking the "smoking interests" . identical with the tobacco interest: speak of "anti-smoking interests" interests of those who stand to gain or power) from the campaign against =itigation involving smoking. Veste different interpretations of availat .may look to an absolutely disintere smoking scientist from outer space) iuestion, but one that, I think, h Political dynamics of the situation t:at very few people indeed have ei petence to go through the by-now m --:erature on the subject and to for - 7 -

277 .k !d on as t- the .^.ev and power, but of education that supposedly legitimatizes their claims to "know better". The bottom line of this pretension is always "We know what is best for you and, therefore, we have the right to tell you how you should live." In everyday situations, the response of working-class people to such elitist interventionism tends to be quite forceful (and frequently unprintable). Cultural themes are typically related to vested interests of one sort or another. The Temperance Movement kept thundering against the vested interests of the liquor merchants, but in time it was quite correct to speak of "Temperance interests". Similarly, the anti-smoking movement keeps attacking the "smoking interests" .(which are, of course, identical with the tobacco interests); but by now one may also speak of "anti-smoking interests" -- that is, the vested interests of those who stand to gain (be it in terms of privilege or power) from the campaign against the regulation of, or the litigation involving smoking. Vested interests, inevitably, have different interpretations of available data. How the evidence may look to an absolutely disinterested observer (say, a non- smoking scientist from outer space) is an altogether different question, but one that, I think, has little to do with the political dynamics of the situation here and now. (One may add', that verl few people indeed have either the time or the com- petence to go through the by-now massive body of scientifrc literature on the subject and to form an objective view of their ® - 7 -

278 own. It would seem to follow from this obvious fact that most people, on either side of the controversy, will base their res- pective positions on something other than rigorously considered scientific judgment.) These general considerations are relevant in that they lead to the following questions for those who favor this legis- lation: Do they want to further an overall attitude of unrealistic risk-avoidance in the society? Do they want to stig- matize people and lifestyles that deviate from what is considered proper and wholesome in the elite milieus of the society? More specifically, should public policy and law impose upper-middle- class values and lifestyles on the rest of the population? It seems to me that both realism and democratic values incline one toward negative answers to all three questions. In sum: I don't believe that what American society needs right now is a new version of creeping Prohibition. The Issue of Government Power Americans are rightly proud of living in a pluralistic society. In such a society, there will always be conflicts between discrepant values and lifestyles, and evangelism of one's own values and lifestyles is protected by the First Amendment. Also, there will always be conflicting vested interests in such a society, and the idea that these can all be resolved into harmony is utopian and undemocratic. The matter becomes very serious, however, when one ideological party seeks to utilize the powers - 8 - 279 of government in elevating its o interests to monopoly status. In • Federal government, this is doubly and Federal legislation is involv consideration here, there is "an i. issue of government power. important issue. In my The cultural theme of : necessarily lead to an expansion of there are other ways by which indi• themselves from the risks they fea government is increasingly looked guarantor of all desiderata in humz that government should be expected risks they want to avoid. In the e: Since many of the risks individuals a result of their own actions, gover people from themselves -- a curious cratic ideals. Ivan Illich recently pointed oL increasingly taking on the characte becomes mater et magistra, "mother a all nurture and all instruction. Th function of the state is particularl: under consideration here. Surely, General's report on the alleged peri- - 9 -

279 of government in elevating its own values, lifestyles and interests to monopoly status. In view of the vast powers of the Federal government, this is doubly serious when Federal policy and Federal legislation is involved. In the matter under consideration here, there is "an issue behind the issue" -- the issue of government power. In my opinion, that is the most important issue. The cultural theme of risk reduction does not necessarily lead to an expansion of government power. After all, there are other ways by which individuals may want to protect themselves from the risks they fear. But, in an age where government is increasingly looked upon as the provider and guarantor of all desiderata in human life, it is only logical that government should be expected to protect people from the risks they want to avoid. In the end, this produces a paradox. Since many of the risks individuals fear are actually incurred as a result of their own actions, government is expected to protect people from themselves -- a curious inversion of classical demo- cratic ideals. Ivan Illich recently pointed out that the modern state is increasingly taking on the characteristics of the church; it becomes mater et magistra, "mother and teacher," the source of all nurture and all instruction. The "magisterial" or teaching function of the state is particularly evident in the legislation under consideration here. Surely, since the first Surgeon General's report on the alleged perils of smoking, the American - 9 - 0 I

280 tM public has been bombarded with negative communicatiorn about this practice, including the warning notice printed, under penalty of law, on all cigarette packages. It is now alleged that the message has not sufficiently registered and that it ought to be reinforced. One detects here the note of irritation familiar to all teachers whose pupils fail to learn the proper lessons. Such irritation, I suppose, is quite justified when children refuse to learn arithmetic or grammar. In this case, though, it carries the disturbing implication that the American public actually consists of child-like individuals. But what is the evidence for this? As far as I know, the only evidence is that smoking has not declined to the degree that anti-smoking activities would wish. But is it not plausible to argue that adults, with all the information available to them, make their own decisions -- including decisions as to what risks to take? There is something very disturbing about the notion that government in a democracy has a "magisterial" function. It becomes even more disturbing when government pushes its 'teachings" ever more aggressively as people don't take to it in the opinion of the "teachers". A democracy presupposes that its citizens are responsible adults; therefore, when that same government engages in activities that treat citizens as recalcitrant children, they have a right to be offended. The proposed policy of rotational warnings has precisely this character of infantilization: "Now, Johnny, since you haven't learned your lesson, you will •, hundred times . . . - t4acistr< The most troublesome implicit threat of an ever-deer influences in the private lives person will deny that, in a mc protect individuals from risks government denies me the right unaware others. It is quite a d protect me from risks incurred b own actions. An analogous case may drive my car, I obviously risk government, quite rightly, seek government examines and licenses dangerous driving, mandates vari so on. No reasonable person wi: behavior a violation of the indr another matter, though, when gov against the possible risks of my faced in the debate over involu: Should government not only insi: functioning devices that protect and the like), but also devices want them or not, protect me, th without which I cannot start the