Learning to Smoke: Tobacco Use in the West (review)

Hughes sets out to answer the question "Why do people smoke?" by examining the context of the use of tobacco and of the "shifting understandings" (11) of the meaning of the experience of smoking. He traces the use of tobacco in North American Native People, describing it as "a highly important, sacred, and 'male' pursuit ... characterized by a loss of control, by intoxication" (33-4). He then moves to a discussion of the history of tobacco use in Europe, with a view to setting the phenomenon in the context of scientific and cultural change, concluding that both the nature (the emergence of the cigarette and milder strains of tobacco) and the purpose (maintaining or restoring "control") of smoking had changed. The final historical chapter focuses on the twentieth century west, with its increasing emphasis on medical understandings of tobacco; clinical science isolated nicotine as a noxious agent in tobacco smoke and interest in the social and psychological aspects of smoking and smoking behaviour declined. The influence of modern medicine is further illustrated by the rise of the clinic described by Foucault, and the emergence of epidemiological methods to document the "problems" associated with smoking.

Hughes seeks to explain the emergence of governmental regulation of the content of tobacco products as part of a "process that began to gather momentum over four centuries" earlier (138). That process parallelled the development and use of milder strains of tobacco and different forms of tobacco consumption. The time period also saw an increase in the proportion of smokers who are women, and changes in the social acceptability of smoking.

Perhaps the most important part of the book, however, is in its report of Hughes' own work, a qualitative investigation of smoking behaviour. He identifies five "stages" of the smoker's career, modelled after Becker's study of marijuana users. Hughes notes that the stages are not necessarily progressive, nor do all smokers pass through them all. Each of the stages (Beginning Smoking, Continued Smoking, Regular Smoking, Addicted Smoking, Stopping Smoking) is described and illustrated using quotations from the informants in his study.

In the concluding chapter of the book, Hughes relates stages to the historical material presented in the earlier chapters, drawing parallels between individual use of tobacco and the broader development of tobacco use in the west, suggesting that "both are influenced by the processes of civilization" (emphasis in the original) (177). For example, he argues that the beginning smoking stage of tobacco use helped to mark transitions from one life stage to another. For children becoming independent adults, for example, smoking "served a primarily social purpose...often as an act of defiance against parents or society as a whole" (178). He relates this stage to what he has called the "Gemeinschaft of seventeenth-century tobacco use in the West in which the practice was understood to be a mark of sociability and also of defiance against religious edicts, moral treatises and medical arguments" (178).

This account is fascinating, both in its content and in its method. Hughes makes excellent use of a wide array of both primary and secondary sources to document the changes in tobacco itself and in its use, offering a clear path to understanding the place of smoking in modern society. This is a book worth reading for any student of historical sociology, for those interested in qualitative research and for those whose primary focus is on tobacco use. Because it concludes with a section on policy implications, it is also relevant to health planners and to those who seek to understand how social policy relates to social phenomena. He paints a relatively pessimistic picture of the potential success of anti-smoking campaigns directed at young people unless they are able to take into account more explicitly the motivations for smoking, as expressed by the people in his study. Some of specific motivations — stress relief and weight control, for example — need to be addressed in education and prevention programs, in addition to the...