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Marketing Health - Smoking and the Discourse of Public Health in Britain, 1945-2000 (Hardcover)
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Marketing Health - Smoking and the Discourse of Public Health in Britain, 1945-2000 (Hardcover)
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The post war history of public health and the role of smoking
within that history epitomises the tensions which surround taking
health to the public. Public health history has largely
concentrated on the nineteenth century sanitary period or on the
years before the Second World War, often focussing on the
environmental advances, or on the professional and occupational
history of public health as an activity. This book has a different
focus: it deals with the change in the outlook of public health
post war. From a focus on services, vaccination, and dealing with
health issues at the local level, public health had developed new
discourse. Centring on chronic disease, it became concerned with
the concept of "risk" and targeted individual behaviour. The mass
media and centralised campaigning directed at the whole population
replaced local campaigns, and politicians changed their mind about
speaking directly to the public on health matters. Their early
worries about the 'nanny state' gave place to a desire to inculcate
new norms of behaviour, and it was debated how change was to be
achieved.
Identifying debates between those believing in "systematic
gradualism" and those who advocated a more coercive approach,
Virginia Berridge uses smoking as a model. Such debates brought
into play tensions over the relationships between public health and
industrial interests. Health campaigning by new style pressure
groups like ASH, which were part state funded, was an important
motive force behind the change.
In the 1980s and 1990s, public health changed again. Passive
smoking and HIV/AIDS brought environmental concerns back into
public health, which had disappeared after the 1950s. The "rise
ofaddiction" for smoking demonstrated the power of pharmaceutical
interests to define a new "pharmaceutical public health" in which
treatment and "magic bullets" were also tactics for prevention. In
the early 21st century, public health was play to complex tensions
and conflicting impetuses. This book shows that those tensions were
nothing new and outlines their development over the last half
century.
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