Unfiltered: Conflicts over Tobacco Policy and Public Health

UNFILTERED: CONFLICTS OVER TOBACCO POLICY AND PUBLIC HEALTH Eric Feldman and Ronald Bayer (eds) Cambridge MA, London UK: Harvard University Press 2004, PB 396 pp, AUD 85.00 ISBN 0-67401334-4Unfiltered: Conflicts over Tobacco Policy and Public Health provides a comparative analysis of tobacco control policies in eight liberal democracies: the United States, Japan, Canada, Australia, the United Kingdom, France, Germany and Denmark. It also describes the European Union's efforts to establish coherence in tobacco control policies in its member states. These 'policy portraits' make up the first nine chapters of Unfiltered, giving the 'thick description' that illuminates the way historical, social and cultural factors interact to produce a range of policy outcomes in tobacco control. Chapters ten and eleven highlight the challenges and benefits of cross-cultural analysis in tobacco control policy and discuss why the same constellation of policies applied in different contexts, do not necessarily produce the same result.Together the national histories reveal the difficulties of introducing policies that may be seen to limit individual freedom in countries with a liberal democratic tradition. For example Ronald Bayer and James Colgrove show how, in the United States, anti-tobacco advocates succeeded in overcoming general antagonism to government regulation and paternalism by arguing for the protection of young people from tobacco promotion and the right of 'bystanders' to be free from sidestream-smoke. Similarly, in Canada, Christopher Manfredi and Antonia Maioni show that it was the appeal to the prevention of smoking by children that won the argument for tobacco control, both in the early 20th century and again in the 1990s. Germany, in contrast, did not succeed in overcoming antipaternalist sentiment. Giinter Frankenburg describes how the cultural memory of the Nazi anti-smoking campaigns for 'racial hygiene', the presence of a powerful pro-tobacco lobby and the lack of an effective grassroots anti-tobacco movement worked against the introduction of strong tobacco control measures. Similarly in France and Denmark, an ethos of individual freedom combined with a dislike of US puritanism, prevented the introduction of the kinds of policies adopted in the US, Canada and Australia.John Ballard's analysis of the development of tobacco control policies in Australia documents the innovations developed by individual states in Australia's federal system in the late 1970s and 1980s, many of which were taken up elsewhere. As Ballard notes, 'The small number of discrete political cultures in the Australian federation-six states and two territories-has enabled different innovative approaches to develop in close proximity of one another, thus creating frequent opportunities for cross-pollination.' However it took longer for the national government to act and it wasn't until 2000 that a comprehensive national tobacco control strategy was adopted. In his examination of tobacco control policies in Japan, Eric Feldman indicates that, unlike Australia, Japan has relied on 'smokers' manners as the basis of the social contract underlying smoking'. Feldman shows why it is difficult to isolate one clear explanation for the Japanese government's apparent lack of concern about tobacco-related morbidity and mortality. They range proposed by commentators includes both fiscal priorities and sociocuttural factors. Nonetheless, he suggests cautiously that there may be an 'emergence of a new politics of public health in Japan', citing the introduction of a new Health Promotion Law in 2003 which has led ten private railway companies to ban smoking in the railway stations they operate. …

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