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Drinking Smoke

Drinking Smoke: The Tobacco Syndemic in Oceania

Mac Marshall
Copyright Date: 2013
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  • Book Info
    Drinking Smoke
    Book Description:

    Tobacco kills five million people every year and that number is expected to double by the year 2020. Despite its enormous toll on human health, tobacco has been largely neglected by anthropologists.Drinking Smokecombines an exhaustive search of historical materials on the introduction and spread of tobacco in the Pacific with extensive anthropological accounts of the ways Islanders have incorporated this substance into their lives. The author uses a relatively new concept called asyndemic-the synergistic interaction of two or more afflictions contributing to a greater burden of disease in a population-to focus at once on the health of a community, political and economic structures, and the wider physical and social environment and ultimately provide an in-depth analysis of smoking's negative health impact in Oceania.InDrinking Smokethe idea of a syndemic is applied to the current health crisis in the Pacific, where the number of deaths from coronary heart disease, cancer, diabetes, and chronic obstructive pulmonary disease continues to rise, and the case is made that smoking tobacco in the form of industrially manufactured cigarettes is the keystone of the contemporary syndemic in Oceania. The author shows how tobacco consumption (particularly cigarette smoking after World War II) has become the central interstitial element of a syndemic that produces most of the morbidity and mortality Pacific Islanders suffer. This syndemic is made up of a bundle of diseases and conditions, a set of historical circumstances and events, and social and health inequities most easily summed up as "poverty." He calls this the tobacco syndemic and argues that smoking is the crucial behavior-the "glue"-holding all of these diseases and conditions together.Drinking Smokeis the first book-length examination of the damaging tobacco syndemic in a specific world region. It is a must-read for scholars and students of anthropology, Pacific studies, history, and economic globalization, as well as for public health practitioners and those working in allied health fields. More broadly the book will appeal to anyone concerned with disease interaction, the social context of disease production, and the full health consequences of the global promotional efforts of Big Tobacco.Mac Marshallis emeritus professor of anthropology and community and behavioral health at the University of Iowa.

    eISBN: 978-0-8248-3796-9
    Subjects: Anthropology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. I-VI)
  2. Table of Contents
    (pp. VII-VIII)
  3. List of Illustrations
    (pp. IX-X)
  4. Preface
    (pp. XI-XII)
  5. Acknowledgments
    (pp. XIII-XIV)
  6. Abbreviations
    (pp. XV-XVI)
  7. Situating Tobacco Chronologically vis-à-vis Oceania
    (pp. XVII-XX)
  8. PART ONE The History, Economy, and Ethnography of Tobacco in Oceania

    • [Part One Introduction]
      (pp. 1-4)

      More than forty years ago, Greg Dening described an ethnohistorian as “a historian who is an amateur anthropologist, or an anthropologist who is an amateur historian, and in consequence the object of suspicion of anthropologist and historian alike” (1966, 23). My ownbona fidesplaces me in the camp of an anthropologist who is an amateur historian, and I rely heavily on secondary sources and upon the work of my trained historian colleagues in the pages to follow as I endeavor to piece together tobacco’s paths, trials, and tribulations in Oceania. I hope that in so doing I will not...

    • Chapter 1 Introduction and Historical Background
      (pp. 5-21)

      This book examines the history, ethnography, and medical anthropology of tobacco in the world region known as Oceania or the Pacific Islands. Part one draws together historical material on the introduction and spread of tobacco in Island Oceania and explores the ways Islanders have incorporated tobacco into their lives as reported by ethnographers. In part two, attention turns to the health problems linked to tobacco—particularly to the smoking of industrially manufactured cigarettes—and the huge burden of sickness this places on individuals, communities, and the various Pacific Island countries and territories (PICTs) in the twenty-first century. The medical anthropological...

    • Chapter 2 Tobacco as a Comestible
      (pp. 22-43)

      At first blush, this expression—“tobacco is my mother’s milk”—may seem odd or even nonsensical. But I believe it encodes several important truths about the place of and the uses for tobacco, not just for a few old women on Sabarl, but also for men and women of all ages in much of Oceania. To equate tobacco with mother’s milk is to emphasize several things at once: tobacco is something essential to life; tobacco is something one obtains from those with whom one has or wishes to have a close relationship; and tobacco is something that one ingests orally...

    • Chapter 3 Pipe Dreams
      (pp. 44-61)

      Europeans mostly consumed tobacco by smoking it. Both Goodman (1993) and Gately (2001) contend that in the British Isles and northern Europe (and their corresponding colonies across the Atlantic), pipes were adopted as a consequence of having encountered New World peoples who smoked pipes. Likewise, they argue that the Spaniards and possibly the Portuguese and residents of their possessions smoked mainly cigars because that was the form of consumption the Iberians had experienced in the New World. As discussed in chapter 1, the earliest incursion of tobacco into the Pacific Islands was on the island of New Guinea, where it...

    • Chapter 4 Tobacco in Indigenous Trade
      (pp. 62-78)

      When colonizing Europeans first ventured ashore on New Guinea in substantial numbers, they encountered tobacco being grown and smoked in many different places. This led to the erroneous idea that a species of tobacco must have been indigenous to the island, and a mini-academic controversy swirled around this subject for a number of years (e.g., Haddon 1931; Laufer 1931; Lewis 1924, 1931; see also Feinhandler, Fleming, and Manahon 1979). Gilmour (1931) tested thirty-six samples from various parts of the island and determined that all were of the New World speciesNicotiana tabacum. With yet more data and impressive ethnological research,...

    • Chapter 5 Tobacco as an Object of Exchange between Islanders and Foreigners
      (pp. 79-100)

      Several historians have remarked that tobacco afforded traders a “perfect” exchange commodity: it was addictive, it was used up quickly, and it was often in short supply even if grown locally. As a drug food, tobacco served as both an inducer and an enhancer of trade (Jankowiak and Bradburd 1996). As an inducer, tobacco encouraged Islanders to give traders goods or labor in return for a nicotine supply; as an enhancer, tobacco helped to increase Islanders’ efficiency, intensity, and duration of work effort (ibid.). Tobacco served as a “powerful inducement” to help lure migrant Melanesian workers into the Queensland labor...

    • Chapter 6 From Tobacco Trade to Tobacco Production
      (pp. 101-117)

      Until 1884 nearly all cigarettes were hand-rolled, and cigarettes were far less popular anywhere in the world than alternative means of taking tobacco: smoking pipes or cigars, snuffing, and chewing. But in April 1884 in Durham, North Carolina, James “Buck” Duke’s relatively small tobacco company¹ altered the tobacco landscape forever by partnering with the inventor of the first machine that could manufacture ready-made cigarettes. Not only did this allow him to cut the retail price of his Duke of Durham cigarettes, but almost immediately he also embarked on a major advertising campaign. Hiring Edward F. Small to run his advertising,...

    • Chapter 7 Death, Taxes, and Tobacco Control
      (pp. 118-140)

      As we will see in subsequent chapters, tobacco has become a major cause of death and disability in Pacific Island countries and territories (PICTs), especially over the past century, as industrially manufactured cigarettes have captured an ever greater number of smokers. According to the World Health Organization’s Western Pacific Regional Office (WHO-WPRO), diseases strongly linked to tobacco smoking are among the three leading causes of death in most of the islands. Cardiovascular diseases were the top reported cause of death in fifteen of the twenty PICTs for which data were available,¹ and respiratory diseases were ranked as the first, second,...

  9. Part Two The Medical Anthropology of Tobacco in Oceania

    • [Part Two Introduction]
      (pp. 141-144)

      The subtitle to this book isThe Tobacco Syndemic in Oceania, and yet until now our primary focus has been on the history and ethnography of tobacco in the Pacific Islands. We have reviewed when and how tobacco reached different island groups, the various ways it was consumed, and by whom. We have seen the many ways this drug food was incorporated into Pacific sociocultural systems and the ways it became an important item of exchange in traditional trading networks. We have reviewed tobacco’s role as commodity money and its significance in economic and social relations between Islanders and foreigners,...

    • Chapter 8 Aotearoa: “Land of the Long White Smoke Cloud”: Pacific Smoke Inhalation Case Study Number 1
      (pp. 145-163)

      This chapter is the first of three “case studies” that chronicle and examine the effects of tobacco use—primarily cigarette smoking—on the health and socioeconomic well-being of Pacific Islanders in three different locations. Selection of these cases has been dictated to some extent by the availability of relevant information. The first and third cases analyze the situation for Fourth World peoples, that is, indigenous Polynesian Islanders submerged by an invading settler society (see Kunitz 1994)—the Māori of Aotearoa/New Zealand in the first instance and Native Hawaiians in the other. The middle case to be examined consists of the...

    • Chapter 9 U.S. Associated Micronesia: Pacific Smoke Inhalation Case Study Number 2
      (pp. 164-178)

      This second case study is of a different sort than the preceding one. In the former instance our attention was focused on two so-called minority ethnic groups¹ in a dominant settler society that is a developed and relatively wealthy country. In U.S. Associated Micronesia—henceforth for ease of reference to be called Micronesia²—we encounter a mix of political entities and a range of linguistically and culturally distinct peoples. What binds them together at this moment in history is their present or former colonial connection to the United States.

      The specific polities to be included here are the Commonwealth of...

    • Chapter 10 Native Hawaiians: Kānaka Maoli: Pacific Smoke Inhalation Case Study Number 3
      (pp. 179-190)

      This final case study of the negative health effects of smoking is focused on “Native Hawaiians,” also called Kānaka Maoli. They will be referred to below as Native Hawaiians since most of the published literature uses this designation. The indigenous Polynesian inhabitants of the Hawaiian archipelago were believed to have numbered about 300,000 at the time Captain James Cook arrived in 1778 (Ito 1999, 39). As a consequence of introduced diseases—notably epidemics of cholera, influenza, measles, whooping cough, and venereal disease—the population plummeted to just over 44,000 by 1878, although out-migration by Hawaiian men as sailors on whaleships...

    • Chapter 11 Tobaccosis: The Tobacco Syndemic
      (pp. 191-224)

      As we launch into a full description and analysis of the tobacco syndemic in this final chapter, a few reminders about syndemics are in order. Please keep in mind that a syndemic is a complex, interrelated, multivariate phenomenon made up of both biological and sociocultural parts. The syndemic lies in the intertwining of these various parts and the ways their combinations affect diseases and health problems. Our concern is specifically with tobaccosis, that is, with how tobacco use connects to and is associated with various biological diseases on the one hand, and with their assorted environmental and sociocultural contexts on...

  10. Notes
    (pp. 225-246)
  11. References Cited
    (pp. 247-284)
  12. Index
    (pp. 285-292)
  13. Back Matter
    (pp. 293-293)