The Tobacco Syndemic in Oceania
Publication Year: 2013
In Drinking Smoke the 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 Smoke is 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 Marshall is emeritus professor of anthropology and community and behavioral health at the University of Iowa.
Published by: University of Hawai'i Press
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Title Page, Copyright, Dedication, Quote
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List of Illustrations
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Forty years ago when I began to research the history of alcoholic bever-ages in Micronesia, I kept running across numerous references to tobacco consumption in ways that predated the rise of modern cigarettes. Although tobacco was not my primary focus back then I routinely recorded this infor-mation for possible future use. I mentioned bits of this historical material ...
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A book such as this owes a scholarly debt to the many people who have mentioned tobacco in their written work, whether but a short passing refer-ence or a more detailed focus on smoking or chewing. Others have assisted my project by sharing unpublished material, pointing me toward sources of which I was unaware, or responding to questions I posed on ASAOnet. ...
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Situating Tobacco Chronologically vis-à-vis Oceania
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...1492 November 5th in Cuba: The first recorded encounter between 1550s Tobacco seeds are carried to France and planted in herbal 1556 A Bristol sailor “created a sensation” by smoking in the street 1575 Spaniards introduce tobacco to the Philippines from Mexico.1590–1610 The Portuguese introduce tobacco to India, Java, and Japan, ...
Part One The History, Economy, and Ethnography of Tobacco in Oceania
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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 anthro-pologist and historian alike” (1966, 23). My own bona fides places me in the camp of an anthropologist who is an amateur historian, and I rely heavily on ...
Chapter 1 Introduction and Historical Background
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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 smok-...
Chapter 2 Tobacco as a Comestible
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The day I first arrived on Sabarl I received a most extraordinary greeting. We had anchored the small mission outboard on the north side of the island and crossed on foot at a narrow point, descend-ing into Maho by a back path. We were spotted first by the elderly flocked to meet us. From a distance they seemed very fragile, but ...
Chapter 3 Pipe Dreams
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...ing. The pipe, whether long-stemmed or in the form of the hookah, 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. ...
Chapter 4 Tobacco in Indigenous Trade
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When colonizing Europeans first ventured ashore on New Guinea in sub-stantial 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 ...
Chapter 5 Tobacco as an Object of Exchange between Islanders and Foreigners
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...[S]uch commodities as tea, coffee, cocoa, sugar, tobacco, and even opium recur so often in the roster of imports and exports during the latter nineteenth century that some scholars have even begun to 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 ...
Chapter 6 From Tobacco Trade to Tobacco Production
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It was the rise of the modern cigarette . . . that most dramatically It is a known fact that factory-made cigarettes are quickly tak-tobacco. This is a direct result of advertising of these products, rettes and tobacco, the convenience of a ready product and empha-sizes the unlimited and unrestricted availability of these products....
Chapter 7 Death, Taxes, and Tobacco Control
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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 ...
Part Two The Medical Anthropology of Tobacco in Oceania
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The subtitle to this book is The 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 ...
Chapter 8 Aotearoa: “Land of the Long White Smoke Cloud”: Pacific Smoke Inhalation Case Study Number 1
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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 ...
Chapter 9 U.S. Associated Micronesia: Pacific Smoke Inhalation Case Study Number 2
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Most of what is imported here in cans and in cigarette packets is slowly, and in many cases not so slowly, poisoning the population 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 ref-...
Chapter 10 Native Hawaiians: Kanaka Maoli: Pacific Smoke Inhalation Case Study Number 3
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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 archi-pelago 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 ...
Chapter 11 Tobaccosis: The Tobacco Syndemic
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Perspectives that recognize syndemic relationships are necessary in studying the health of Pacific peoples given the extent of clustering of disease and other social conditions. They offer a way of assess-ing and developing inter-sectoral approaches to health and disease 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. ...
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Publication Year: 2013