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To smoke or not to smoke: A decision theory perspective
Sm. Sci. Med. Vol. 33, No. 12, pp. 1343-1347, Printed in Great Britain. All rights reserved
0277-9536191 S3.00 + 0.00
1991
Copyright 0 1991 Pergamon Press plc
TO SMOKE OR NOT TO SMOKE: A DECISION PERSPECTIVE MICHAEL C. ROBBINS
Department of Anthropology,
THEORY
and ANNETTE KLINE
200 Swallow Hall, University of Missouri, Columbia, MO 65211, U.S.A.
Abstract-Although smoking as a customary behavior is currently becoming outmoded, and may even be viewed as a ‘deviant’ behavior; its use persists among certain social groups in our own and other societies. We address this issue by describing the inherent design features and benefits of tobacco, and tobacco smoking, and propose that its use be conceptualized as a reasoned act based upon its subjectively perceived net worth to the individual. A survey of the scientific literature is made and cross-cultural examples are used. Key words-tobacco,
decision analysis, cross-cultural
smoking has been extensively studied from the perspective of behavioral decision theory in order to explain its initiation, persistence, and cessation [l-lo]. According to these studies, smoking is conceptualized as a form of reasoned behavior whereby individuals make decisions to smoke or not by cognitively appraising their knowledge of both: (a) the attributes of tobacco and smoking; and (b) the consequences (benefits, costs and risks) of doing so. Included are such considerations as: (1) beliefs that smoking will lead to particular outcomes; (2) the likelihood of these occurring; (3) the positive or negative evaluations of these consequences; (4) beliefs about what other individuals or groups think the person should or should not do and (5) his or her motivation to comply with these perceived social norms. The final choice, or expressed preference, is made on the basis of the overall subjective expected utility (SEU) or perceived net worth (i.e. gain) to that individual. The SEU can be defined, for a course of action, as the sum of the subjective utilities or values associated with that course, each weighted by the subjective probabilities that it will produce these outcomes. Confronted with a choice between two or more alternative courses, (1) smoke or (2) not smoke, SEU theory predicts a person will choose the course of action with the greatest SEU (lo]. As Barbara Loken succinctly states:
Tobacco
One’s overall affect toward smoking may be some combination of.. . positive and negative consequences. For some individuals, such as heavy smokers, the positive consequences may tend to compensate for the negative consequences of smoking. For other individuals, such as nonsmokers the negative consequences may outweigh the positive consequences. Furthermore, normative prescriptions of important others such as friends, and family may influence smoking decisions [8, pp. 61&617].
Therefore, a decision is reasonable if it is aimed at achieving a benefit greater than cost. Fishbein states this clearly: While one may question the values that some . . . place on certain outcomes or the accuracy of some of their beliefs, a decision to smoke is actually quite reasonable if the decision
maker believes that the net effects of smoking are more positive than the net effects of not smoking [4, p. 1021. Tobacco use, of course, is far more than simply a series of isolated, individual acts-indeed, it is a
culturally patterned, social activity governed by rules and conventions, surrounded by custom, with symbolic meanings attached. However, what we see reflected in social behavior or in an actual distribution of tobacco users (e.g. in a prevalence ratio of smokers in a population) is the outcome of a multiplicity of individual decisions to smoke or not, which in their cumulative effect, generate this observed distribution. It is proposed here that in order to explain the distribution of tobacco use in any population, in terms of its initiation and persistence, tobacco usevalues and behaviors must be studied at the individual as well as at the societal level. This in turn implies investigating the decision making progress of individuals in given socioculturally constituted situations. We now address the design features and individual and social utilities of tobacco that collectively, appear to engender its use-value. In this regard, we have adopted a cross-cultural perspective because we believe it is essential to a broader understanding of its diversity in form, meaning and uses. This diversity cannot be gleaned solely from observations of the diminished and stigmatized use of tobacco in our society today [l 11. Examples will therefore be drawn from both the United States, including our fieldwork, and the cross-cultural literature. DESIGN
FEATURES
Tobacco has several inherent attributes that imbue it with both personal and social utility. Few, if any currently available alternatives (e.g. gum, candy, food, diet soft drinks, coffee, alcoholic beverages, etc.), possess this set of characteristics. Among these are the following: Malleability
Tobacco can be physically shaped and used in many forms (pipe, cigar, cigarette, snuff, chew,
1343
1344
MICHAEL
C.
ROBBINS and ANNEX
KLINE
decoction, etc.); and used in many ways (smoked, chewed, sniffed, imbibed, licked, etc.). Black notes, that as an innovation like metal or cloth, it also comes without symbolic specificity and can therefore be easily shaped into useful cultural forms as well [12, pp. 48&481].
Equipped with these design characteristics and convenience features, tobacco readily acquires its utility for the individual in a variety of social and cultural settings.
Portability
SociaI interaction
Tobacco is easily and conveniently ous forms and quantities.
carried in vari-
Accessibility
Tobacco is widely available, easily obtained, relatively inexpensive.
and
DurabiIity
Tobacco is storable, retainable, for long durations.
and can be saved
Divisibility
Tobacco is partible into countable or measurable quantities for personal use, storage or exchange. Dispensability
Coupled with divisibility, tobacco is shareable and easily distributed in discrete or continuous quantities. The appropriate amount can be varied easily to fit the situation (cigar, carton, toke, drag, large cache, lump payment, etc.) so that as a gift, “it is neither too little nor too much” [12, p. 4871. Testable
Tobacco is capable of incremental use in small or large amounts and in various forms. It can therefore be self-tested for pleasurable or aversive properties and its use is relatively simple to learn. Perceptibility
Tobacco can be exhibited or concealed. It can convey, via thermal, visual and tactile signals, a person’s mood, social status or definition of the situation. Compatibility
In an instrumental sense, tobacco use is compatible because other actions and thoughts can be performed while using it (i.e. walking, talking, reading, manipulating, driving, operating machines, etc.). Chemical qualities
Tobacco use effects the autonomic and central nervous systems. Although the mechanisms are far from clear, research suggests that tobacco use can increase alertness, and ward off hunger, fatigue and pain [13-161. It is also a chemical sensory stimulant. It is processed with sweeteners and flavorings and as an ingestible akin to coffee, food, and alcohol, its stimuli supply a taste (and smell) for which an appetitive preference can be acquired [16]. It is noncaloric. As a manipulable form of oral gratification it can serve as a food substitute without weight gain. Studies show that smokers as a group weigh less than nonsmokers and that they tend to gain weight when they stop smoking [17-191.
INDIVIDUAL
AND SOCIAL
UTILITIES
It can be used to foster reciprocity and friendship by exchange and can mediate the social interaction process. Almost universally, tobacco has served as a valued mark of ‘hospitality’ [ 12,20,21]. This happens from the most casual request for, or offer of, a cigarette to initiate contact in our society, through a complex of reciprocal cycles of tobacco exchanges in others. An example of these is described for the Tobi of Micronesia by Black who concludes “ . . . smoking is almost always a social act and used for interactional ends-to establish and maintain socially appropriate relationships” [12, p. 4851. Other examples are legion. Among the Karuk of northern California, for instance: When men or doctor women met together on the trail or elsewhere it was the regular custom to offer each other their pipes, each himself smoking first in true Indian style. This smoking p. 1I].
is regarded
the same
as a friendly
embrace
[22,
And in the Gilbert Islands of Oceania, it was noted that, “pressing a cigarette or other small object discreetly into a girl’s hand signals an interest in intercourse; a favorable reply can be given in the same manner” [23]. Among the Gebusi of Papua New Guinea, Knauft describes how tobacco giving is considered essential social etiquette that can be manipulated to insure peaceful interactions. In fact, it is such a strong symbol of friendly interaction that to smoke alone is considered bad etiquette [24]. Moreover, stages in the smoking process (e.g. light-up, drag, exhale and the put-out) signal and coordinate transitions in speakers, topics, and other interaction events. The Kikuyu of Kenya, for example, suggest a pinch of snuff when they desire a change in topic or mode of communication [21]. In an extensive, naturalistic study of smoking behavior in American society, Clark [25] illustrates various stages in the social process of smoking: Light-up. Prior to initiating behavior (e.g. beginning to speak, change topic). Drags and taps. When silent and others speaking, when others looking elsewhere, taps occur with speaker looking downward. Exhale. Directed at someone creates barrier, but in line of regard, attracts their eyes to smoker. Holding. Distance to mouth inversely related to active involvement. Put-out. Culmination of action. “Smoking behaviors coincide generally with the points in the interaction in which the smoker either is in or is shifting into a passive stance, as indicated by his looking away from others and being silent” [25, p. 2671. In general, the potentiating effect of pleasant mood, friendly offers and exchanges of tobacco and paraphernalia and the mediation of the interaction
To smoke or not to smoke: a decision theory perspective
process all serve to enhance tobacco.
the social utility of
Social meaning
Tobacco is often used as an important symbol of personal, social and cultural identification [26]. It can communicate social roles and statuses; and is usually a prerogative of the privileged, and admired. Among the Tobi of Micronesia, smoking confers adult status. As Black observes: Young people have a long and difficult struggle establishing themselves as fully mature, competent people . . . One of the first steps in this progress is successful establishment of the identity of smoker [12, p. 4921.
In some societies gender status is also communicated. For example among the Karuk of northern California, men smoke and women do not [22]; and among the Baganda of Uganda, traditionally women smoked and men did not. Smoking can also communicate socioculture sub-groups whose maturity and autonomy from adult authority is established through cigarette use [27,28]. There are also those whose sociocultural identity is made manifest by its renunciation (e.g. Mormons, Muslims, and 7th Day Adventists). More broadly, tobacco use can, because of its symbolic meanings, be considered a genre of social communication. In a study of family and social dynamics, Doherty and Whitehead found that the initiation of smoking, or offer of a cigarette, constitutes a vital form of interpersonal communication involving a range of messages concerning relations of inclusion (‘let’s talk’); exclusion (‘I need to be alone’); intimacy (‘let’s relax together’); dominance and independence (I’m my own boss’); etc. [26]. Social competence
Tobacco can enhance the personal characteristics associated with the ability to perform necessary or desired roles and tasks [29-41]. This is accomplished by aiding composure through positive and negative emotion management and by facilitating perceptual and cognitive skills. These studies suggest that performance levels can be maintained despite the disruptive effects of anger, stress, and frustration. These effects have not gone unnoticed in crosscultural research [42]. Returning to the Gebusi of Papua New Guinea, Knauft notes that tobacco smoking ceases hostility between warring parties and culminates in social camaraderie. The Gebusi say tobacco “ ‘cuts the breath’ of visitors, undercutting the ‘strength/anger’ ” (24, p. 781. And Brebeauf writing in 1639 observes:
1345
archives, etc.); and how practices such as tobacco use that enhance memory, and information storage, may be of adaptive value. Smoking as diversion or time-out during social interaction has been studied by Clark who notes that: . . smokers allow themselves to become more involved in a social interaction when they know they have at their disposal an avenue for momentary withdrawal. If, . . they experience momentary anxiety, the cigarette is available for brief withdrawals. These withdrawals, marked by broken eye or verbal contact, may last only seconds; but the self-involvement which comprises the withdrawal allows for a certain composing of oneself and consequent handling of the anxiety [25, pp. 268-2691. This point is aptly illustrated by Paul Theroux, in his book, Riding the Iron Rooster: by Train Through China, in a conversation with a Chinese who was seized by the Red Guards: I was under arrest. That’s when I started smoking. I discovered that if you smoked it gave you time to think. They had me in a room-the Red Guards. Thev- said. “You called Mao’s wife, Jiang Quing, a crazy lady”. She was a crazy lady But I just lit a cigarette and puffed on it so that I could think of something to say [44, p. 1231. It is probably no accident that in our society people from occupational groups with higher prevalence and consumption rates and lower cessation rates are those who continue to find smoking pleasurable and rewarding, because their jobs demand vigilance under unusually stressful conditions (e.g. waitresses, law enforcement officials, other night-shift workers, truck drivers, laborers, machine operators, nurses, sales workers, managers and administrators, and fishermen) [45+7]. Smoking has also been related to perceived job stress and dissatisfaction within various occupations (e.g. nurses, naval officers, fishermen, kibbutzim members, etc.) [31,45]. For many of these workers smoking can be seen as an occupational role adaptation [29,31,37,40,41,45]. From the perspective of commercial shrimpfishermen, for example, who man electronic and mechanical equipment, in isolated and dangerous situations (e.g. monitoring Loran C-Plotters at night, alone at the wheel, fatigued and drowsy during rough weather) the benefits of mental and physical stimulation afforded by cigarettes (preservation of life and boat) can quite easily be seen to outweigh subjectively, any remote future risks. As one shrimper responded during our fieldwork, when asked about cigarettes, “How else are you gonna stay awake All you’re doing is sitting there. You got an automatic pilot on and you set a course and drag it . . . and make sure you don’t get hung up on something” [45].
(The Huron) believe there is nothing so suitable as Tobacco to appease the passions; that is why they never attend a council without a pipe or calumet in their mouths. The smoke, they say gives them intelligence, and enables them to see clearly through the most intricate matters [43, p. 2191. Several studies show that memory consolidation can be aided through tobacco use [29,38,40,41]. It would be interesting to explore the premium placed on long term memory in nonliterate cultures without extensive or efficient means of extrasomatic information storage (e.g. books, computers, libraries,
Sociocultural integration
Tobacco possesses both instrumental and expressive value as an integral component of numerous cultural beliefs and practices. It has figured prominently in: secular public ceremonies and sacred rituals (e.g. bridgewealth payments, peace and war pipes, etc.) [48]; religious practices (e.g. prayer and divination, etc.) (491; health and medicinal therapies (such as salves for wounds, as an analgesic and anesthetic, etc.) [SO, 511; Springer [43], for example, lists 32
1346
MICHAELC. ROBBINSand ANNETTEKLINE
sacred and secular uses of tobacco just in the Eastern Native American culture area alone! Socioeconomic
commodity
Tobacco serves as a medium of exchange, luxury good, trade item and cash crop. These economic values and their social ramifications are well recognized in most societies. In sum due to its numerous, unique, inherent attributes working alone, and in concert, tobacco smoking is reasonably selected for the benefits it provides the individual, and in aggregate, the society and culture in (1) enhancing mood, mental state, social behavior and enjoyment of life and (2) coping with negative feelings, stress and physical problems.
stances are used, will assure a deeper, more balanced and hence more usable foundation of knowledge about tobacco use motives, values and behavior. A cross-cultural assessment of both the benefits and risks of tobacco from a decision-making perspective is therefore essential. REFERENCES
1. Bauman
K. E., Fisher L. A., Bryan E. S. and Chenoweth L. Antecedents, subjective expected utility, and behavior: A panel study of adolescent cigarette smoking. Addict. Eehav. 9. 121-136. 1984. 2. Chassin L., Presson C. C:, Bensenberg M., Corty E., Olshavsky R. W. and Sherman S. J. Predicting adolescents’ intentions to smoke cigarettes. J. Hlth Sot. Behav. 22, 445-455,
CONCLUSION
Although smoking as a customary behavior is currently becoming outmoded in American society, and is associated with a number of diseases such as lung cancer, chronic lung disease and coronary heart disease [46,47], its use still persists among certain social groups. Some would believe these individuals are ignorant of anti-smoking information or confused by advertising. The overwhelming bulk of evidence suggests however that the populace at all levels is informed about the negative consequences associated with tobacco use, particularly the attendant health risks. They have not only been exposed to this information, they appear to be convinced by it. For example, a 1985 survey indicated that 92% of Americans understood that smoking increases an individual’s risk for emphysema and 95% understood it increased the risk for lung cancer [52]. From the perspective of behavioral decision theory it is obvious that knowledge and beliefs about negative health consequences alone do not govern choice-making. As Loken states: . . a person’s beliefs about the health consequences of smoking need not be the major determinant of smoking behavior. Other negative consequences, such as bad odors or unnecessary expense, and the many positive consequences, such as relaxation, pleasant taste, keeping weight down, or relieving nervous tension may also influence smoking decisions [8, p. 6161. The aforementioned individual and social utilities of tobacco must be considered in any study seeking to explain variation in tobacco use and cessation. That tobacco use is still prominent among certain socioeconomic groups; and that many of these experience powerlessness and occupational stress suggests tobacco can be recruited as a stress reducing, coping mechanism (for the reasons mentioned above). Those who have the most to gain from smoking will undoubtedly choose to continue. Tobacco will thus continue to be used because of its subjectively perceived benefits unless either stress is reduced or acceptable alternatives are found. In the recent past, anthropologists have displayed a reasonable liberalism and objectivity in studying other substances like alcohol [23, 531; coca (54,551; peyote and other hallucinogens [56, 571. Only research such as this, where context, meaning, and form are taken into consideration to determine why sub-
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II. Troyer R. and Markle G. Cigarettes: The Battle Over Smoking. Rutgers University Press, New Brunswick, 1983. 12. Black P. The anthropology of tobacco use: Tobian data and theoretical issues. J. Anthropol. Res. 40, 475-503, 1984. 13. Gilbert D. Paradoxical tranquilizing and emotion reducing effects of nicotine. Psychol. Bull. 86, 643-61, 1979.
14. Pomerleau 0. and Pomerleau C. Neuroregulators and the reinforcement of smoking: Towards a biobehavioral explanation. Neurosci. Biobehav. Rev. 8, 503-5 13, 1984. IS. Russell M. Tobacco smoking and nicotine dependence. In Research Advances in Akohol and Drug Problems, No. 3 (Edited bv Gibbins R.. Israel Y.. Kalant H., Popham R., Schmidt W. and’Smart R).. Wiley, New York, 1976. 16. Kozlowski L. The determinants of tobacco use: Cigarette smoking in the context of other forms of tobacco use. Can. J. Publ. Hlth 73, 236-241,
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17. Blitzer P., Rimm A. and Giefer E. Effect of cessation of smoking on body weight of 57,032 women. J. Chronic Disorder 30, 415, 1977.
18. Comstock G. and Stone R. Changes in body weight and subcutaneous fatness related to smoking habits. Arch. Em. Hlth 24, 271, 1972.
19. Kholsa T. and Lowe C. Obesity and smoking habits. Br. Med. J. 4, IO, 1972.
20. Dredge P. C. Smoking in Korea. Korea J. 20(4), 25-36, 1980. 21. Feinhandler S. The social role of smoking. In Smoking in Sociery (Edited by Tolison R.), pp. 167-187. Lexington, Toronto, 1986.
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To smoke or not to smoke: a decision theory perspective 22. Harrington J. Tobacco among the Karuk Indians of California. In Smithsonian Institufion Bureau of American Ethnology, Bulletin 94. U.S. Gov’t Printing Office, Washington, D.C., 1932. 23. Marshall M. (Ed.) Beliefi. Behaviors. and Alcoholic Beverages: A ‘Cross-CuI&al Survey.. University of Michigan Press, Ann Arbor, 1979. 24. Knauft B. M. Managing sex and anger; Tobacco and Kava use among the Gebusi of Papua, New Guinea. In Drugs in Western Pacific Societies: Relations of Substance (Edited by Lamont Lindstrom), pp. 73-98. University Press of America, Lanham, MD, 1987. 25. Clark R. Cigarette smoking in social interaction. Inf. J. Addict. 13, 257-269,
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26. Doherty W. and Whitehead D. The social dynamics of cigarette smoking: A family systems perspective. Fam. Process 25, 453-459,
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27. Eckert P. Beyond the statistics of adolescent smoking. Am. J. Publ. Hlth 73, 439-441,
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41. Warburton D. The functions of smoking. In Tobacco Smoking and Nicotine, A Neurobiologicai Approach (Edited by Martin W., Van Loon G., Iwamoto E. and Davis D.) pp. 51-61. Plenum Press, New York, 1987. 42. Damon A., Maranda P., Maranda E. K., Gehan J. R., Konner M. J., Konner M. S., Mitchell D. D., Mitchell J. N., Pollnac R. B., Robbins M. C., Ross H. M. and Rutherford J. Smoking attitudes and practices in seven preliterate societies. In Smoking Behavior: Motives and Incentives (Edited by Dunn L.), pp. 219-230. Washington, Winston, 1973. 43. Springer J. An ethnohistoric study of the smoking complex in eastern North America. Ethnohisfory 28, 217-35,
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28. Robb J. H. Smoking as an anticipatory rite of passage; Some sociological hypotheses on health-related behavior. Sot. Sci. Med. 23(6), 621-627, 1986. 29. Ashton H. and Stepney R. Smoking: Psychology and Pharmacology. Tavistock Publications, London, 1982. 30. Warburton D. M. and Wesnes K. Individual differences in smoking and attentional performances. In Smoking Behavior:
nonsmokers cigarette consumption. J. Res. Pers. 17, 242-255, 1983. 40. Wesnes K. and Warburton D. Smoking, nicotine and Pharmac. Therapeutics 21, human performance.
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44. Theroux P. Riding the Iron Rooster: By Train Through China. Putnam’s, New York, 1988. 45. Kline A., Robbins M. and Thomas J. Smoking as an occupational adaptation among shrimpfishermen. Hum. Org. 48(4), 351-355,
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46. U.S. Department of Health and Human Services. The Health Consequences of Smokingfor Women: A Report of rhe Surgeon General. Office on Smoking and Health,
Washington, D.C., 1985. 47. U.S. Department of Health and Human Services. The Health Consequences of Smoking, Cancer and Chronic Lung Disease in the Workplace. Office on Smoking and
Health. U.S. Government Printing Office. Washineton. _ DC., i985. C., Marriage among the Palawan. 48. MacDonald L’Homme
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50. Janiger 0. and Dobkin de Rios M. Suggestive hallucinogenic properties of tobacco. Med. Anthrop. Newslerter 4, 6-l 1, 1973. 51. Kell K. T. Tobacco in folk cures in Western society. J. Am. Folklore 78(308), 99-114,
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pp. 405-415, Vol. 2. Plenum Press, New York, 1984. 54. Hanna J. Coca leaf use in southern Peru: Some biosocial aspects. Am. Anthropol. 76, 281-296, 1974. 55. Bolton R. Andean coca chewing: A metabolic perspective. Am. Anrhropol. 78, 630-634, 1976. . . 56. Dobkin de Rios, M. and Smith D. Using or abusing? An anthropologic approach to the study of psychoactive drugs. J. Psychedelic Drugs 8, 263-266, 1976. 57. Harner M. (Ed.) Hailucinogens and Shamanism. Oxford University Press, New York, 1973.
0277-9536191 S3.00 + 0.00
1991
Copyright 0 1991 Pergamon Press plc
TO SMOKE OR NOT TO SMOKE: A DECISION PERSPECTIVE MICHAEL C. ROBBINS
Department of Anthropology,
THEORY
and ANNETTE KLINE
200 Swallow Hall, University of Missouri, Columbia, MO 65211, U.S.A.
Abstract-Although smoking as a customary behavior is currently becoming outmoded, and may even be viewed as a ‘deviant’ behavior; its use persists among certain social groups in our own and other societies. We address this issue by describing the inherent design features and benefits of tobacco, and tobacco smoking, and propose that its use be conceptualized as a reasoned act based upon its subjectively perceived net worth to the individual. A survey of the scientific literature is made and cross-cultural examples are used. Key words-tobacco,
decision analysis, cross-cultural
smoking has been extensively studied from the perspective of behavioral decision theory in order to explain its initiation, persistence, and cessation [l-lo]. According to these studies, smoking is conceptualized as a form of reasoned behavior whereby individuals make decisions to smoke or not by cognitively appraising their knowledge of both: (a) the attributes of tobacco and smoking; and (b) the consequences (benefits, costs and risks) of doing so. Included are such considerations as: (1) beliefs that smoking will lead to particular outcomes; (2) the likelihood of these occurring; (3) the positive or negative evaluations of these consequences; (4) beliefs about what other individuals or groups think the person should or should not do and (5) his or her motivation to comply with these perceived social norms. The final choice, or expressed preference, is made on the basis of the overall subjective expected utility (SEU) or perceived net worth (i.e. gain) to that individual. The SEU can be defined, for a course of action, as the sum of the subjective utilities or values associated with that course, each weighted by the subjective probabilities that it will produce these outcomes. Confronted with a choice between two or more alternative courses, (1) smoke or (2) not smoke, SEU theory predicts a person will choose the course of action with the greatest SEU (lo]. As Barbara Loken succinctly states:
Tobacco
One’s overall affect toward smoking may be some combination of.. . positive and negative consequences. For some individuals, such as heavy smokers, the positive consequences may tend to compensate for the negative consequences of smoking. For other individuals, such as nonsmokers the negative consequences may outweigh the positive consequences. Furthermore, normative prescriptions of important others such as friends, and family may influence smoking decisions [8, pp. 61&617].
Therefore, a decision is reasonable if it is aimed at achieving a benefit greater than cost. Fishbein states this clearly: While one may question the values that some . . . place on certain outcomes or the accuracy of some of their beliefs, a decision to smoke is actually quite reasonable if the decision
maker believes that the net effects of smoking are more positive than the net effects of not smoking [4, p. 1021. Tobacco use, of course, is far more than simply a series of isolated, individual acts-indeed, it is a
culturally patterned, social activity governed by rules and conventions, surrounded by custom, with symbolic meanings attached. However, what we see reflected in social behavior or in an actual distribution of tobacco users (e.g. in a prevalence ratio of smokers in a population) is the outcome of a multiplicity of individual decisions to smoke or not, which in their cumulative effect, generate this observed distribution. It is proposed here that in order to explain the distribution of tobacco use in any population, in terms of its initiation and persistence, tobacco usevalues and behaviors must be studied at the individual as well as at the societal level. This in turn implies investigating the decision making progress of individuals in given socioculturally constituted situations. We now address the design features and individual and social utilities of tobacco that collectively, appear to engender its use-value. In this regard, we have adopted a cross-cultural perspective because we believe it is essential to a broader understanding of its diversity in form, meaning and uses. This diversity cannot be gleaned solely from observations of the diminished and stigmatized use of tobacco in our society today [l 11. Examples will therefore be drawn from both the United States, including our fieldwork, and the cross-cultural literature. DESIGN
FEATURES
Tobacco has several inherent attributes that imbue it with both personal and social utility. Few, if any currently available alternatives (e.g. gum, candy, food, diet soft drinks, coffee, alcoholic beverages, etc.), possess this set of characteristics. Among these are the following: Malleability
Tobacco can be physically shaped and used in many forms (pipe, cigar, cigarette, snuff, chew,
1343
1344
MICHAEL
C.
ROBBINS and ANNEX
KLINE
decoction, etc.); and used in many ways (smoked, chewed, sniffed, imbibed, licked, etc.). Black notes, that as an innovation like metal or cloth, it also comes without symbolic specificity and can therefore be easily shaped into useful cultural forms as well [12, pp. 48&481].
Equipped with these design characteristics and convenience features, tobacco readily acquires its utility for the individual in a variety of social and cultural settings.
Portability
SociaI interaction
Tobacco is easily and conveniently ous forms and quantities.
carried in vari-
Accessibility
Tobacco is widely available, easily obtained, relatively inexpensive.
and
DurabiIity
Tobacco is storable, retainable, for long durations.
and can be saved
Divisibility
Tobacco is partible into countable or measurable quantities for personal use, storage or exchange. Dispensability
Coupled with divisibility, tobacco is shareable and easily distributed in discrete or continuous quantities. The appropriate amount can be varied easily to fit the situation (cigar, carton, toke, drag, large cache, lump payment, etc.) so that as a gift, “it is neither too little nor too much” [12, p. 4871. Testable
Tobacco is capable of incremental use in small or large amounts and in various forms. It can therefore be self-tested for pleasurable or aversive properties and its use is relatively simple to learn. Perceptibility
Tobacco can be exhibited or concealed. It can convey, via thermal, visual and tactile signals, a person’s mood, social status or definition of the situation. Compatibility
In an instrumental sense, tobacco use is compatible because other actions and thoughts can be performed while using it (i.e. walking, talking, reading, manipulating, driving, operating machines, etc.). Chemical qualities
Tobacco use effects the autonomic and central nervous systems. Although the mechanisms are far from clear, research suggests that tobacco use can increase alertness, and ward off hunger, fatigue and pain [13-161. It is also a chemical sensory stimulant. It is processed with sweeteners and flavorings and as an ingestible akin to coffee, food, and alcohol, its stimuli supply a taste (and smell) for which an appetitive preference can be acquired [16]. It is noncaloric. As a manipulable form of oral gratification it can serve as a food substitute without weight gain. Studies show that smokers as a group weigh less than nonsmokers and that they tend to gain weight when they stop smoking [17-191.
INDIVIDUAL
AND SOCIAL
UTILITIES
It can be used to foster reciprocity and friendship by exchange and can mediate the social interaction process. Almost universally, tobacco has served as a valued mark of ‘hospitality’ [ 12,20,21]. This happens from the most casual request for, or offer of, a cigarette to initiate contact in our society, through a complex of reciprocal cycles of tobacco exchanges in others. An example of these is described for the Tobi of Micronesia by Black who concludes “ . . . smoking is almost always a social act and used for interactional ends-to establish and maintain socially appropriate relationships” [12, p. 4851. Other examples are legion. Among the Karuk of northern California, for instance: When men or doctor women met together on the trail or elsewhere it was the regular custom to offer each other their pipes, each himself smoking first in true Indian style. This smoking p. 1I].
is regarded
the same
as a friendly
embrace
[22,
And in the Gilbert Islands of Oceania, it was noted that, “pressing a cigarette or other small object discreetly into a girl’s hand signals an interest in intercourse; a favorable reply can be given in the same manner” [23]. Among the Gebusi of Papua New Guinea, Knauft describes how tobacco giving is considered essential social etiquette that can be manipulated to insure peaceful interactions. In fact, it is such a strong symbol of friendly interaction that to smoke alone is considered bad etiquette [24]. Moreover, stages in the smoking process (e.g. light-up, drag, exhale and the put-out) signal and coordinate transitions in speakers, topics, and other interaction events. The Kikuyu of Kenya, for example, suggest a pinch of snuff when they desire a change in topic or mode of communication [21]. In an extensive, naturalistic study of smoking behavior in American society, Clark [25] illustrates various stages in the social process of smoking: Light-up. Prior to initiating behavior (e.g. beginning to speak, change topic). Drags and taps. When silent and others speaking, when others looking elsewhere, taps occur with speaker looking downward. Exhale. Directed at someone creates barrier, but in line of regard, attracts their eyes to smoker. Holding. Distance to mouth inversely related to active involvement. Put-out. Culmination of action. “Smoking behaviors coincide generally with the points in the interaction in which the smoker either is in or is shifting into a passive stance, as indicated by his looking away from others and being silent” [25, p. 2671. In general, the potentiating effect of pleasant mood, friendly offers and exchanges of tobacco and paraphernalia and the mediation of the interaction
To smoke or not to smoke: a decision theory perspective
process all serve to enhance tobacco.
the social utility of
Social meaning
Tobacco is often used as an important symbol of personal, social and cultural identification [26]. It can communicate social roles and statuses; and is usually a prerogative of the privileged, and admired. Among the Tobi of Micronesia, smoking confers adult status. As Black observes: Young people have a long and difficult struggle establishing themselves as fully mature, competent people . . . One of the first steps in this progress is successful establishment of the identity of smoker [12, p. 4921.
In some societies gender status is also communicated. For example among the Karuk of northern California, men smoke and women do not [22]; and among the Baganda of Uganda, traditionally women smoked and men did not. Smoking can also communicate socioculture sub-groups whose maturity and autonomy from adult authority is established through cigarette use [27,28]. There are also those whose sociocultural identity is made manifest by its renunciation (e.g. Mormons, Muslims, and 7th Day Adventists). More broadly, tobacco use can, because of its symbolic meanings, be considered a genre of social communication. In a study of family and social dynamics, Doherty and Whitehead found that the initiation of smoking, or offer of a cigarette, constitutes a vital form of interpersonal communication involving a range of messages concerning relations of inclusion (‘let’s talk’); exclusion (‘I need to be alone’); intimacy (‘let’s relax together’); dominance and independence (I’m my own boss’); etc. [26]. Social competence
Tobacco can enhance the personal characteristics associated with the ability to perform necessary or desired roles and tasks [29-41]. This is accomplished by aiding composure through positive and negative emotion management and by facilitating perceptual and cognitive skills. These studies suggest that performance levels can be maintained despite the disruptive effects of anger, stress, and frustration. These effects have not gone unnoticed in crosscultural research [42]. Returning to the Gebusi of Papua New Guinea, Knauft notes that tobacco smoking ceases hostility between warring parties and culminates in social camaraderie. The Gebusi say tobacco “ ‘cuts the breath’ of visitors, undercutting the ‘strength/anger’ ” (24, p. 781. And Brebeauf writing in 1639 observes:
1345
archives, etc.); and how practices such as tobacco use that enhance memory, and information storage, may be of adaptive value. Smoking as diversion or time-out during social interaction has been studied by Clark who notes that: . . smokers allow themselves to become more involved in a social interaction when they know they have at their disposal an avenue for momentary withdrawal. If, . . they experience momentary anxiety, the cigarette is available for brief withdrawals. These withdrawals, marked by broken eye or verbal contact, may last only seconds; but the self-involvement which comprises the withdrawal allows for a certain composing of oneself and consequent handling of the anxiety [25, pp. 268-2691. This point is aptly illustrated by Paul Theroux, in his book, Riding the Iron Rooster: by Train Through China, in a conversation with a Chinese who was seized by the Red Guards: I was under arrest. That’s when I started smoking. I discovered that if you smoked it gave you time to think. They had me in a room-the Red Guards. Thev- said. “You called Mao’s wife, Jiang Quing, a crazy lady”. She was a crazy lady But I just lit a cigarette and puffed on it so that I could think of something to say [44, p. 1231. It is probably no accident that in our society people from occupational groups with higher prevalence and consumption rates and lower cessation rates are those who continue to find smoking pleasurable and rewarding, because their jobs demand vigilance under unusually stressful conditions (e.g. waitresses, law enforcement officials, other night-shift workers, truck drivers, laborers, machine operators, nurses, sales workers, managers and administrators, and fishermen) [45+7]. Smoking has also been related to perceived job stress and dissatisfaction within various occupations (e.g. nurses, naval officers, fishermen, kibbutzim members, etc.) [31,45]. For many of these workers smoking can be seen as an occupational role adaptation [29,31,37,40,41,45]. From the perspective of commercial shrimpfishermen, for example, who man electronic and mechanical equipment, in isolated and dangerous situations (e.g. monitoring Loran C-Plotters at night, alone at the wheel, fatigued and drowsy during rough weather) the benefits of mental and physical stimulation afforded by cigarettes (preservation of life and boat) can quite easily be seen to outweigh subjectively, any remote future risks. As one shrimper responded during our fieldwork, when asked about cigarettes, “How else are you gonna stay awake All you’re doing is sitting there. You got an automatic pilot on and you set a course and drag it . . . and make sure you don’t get hung up on something” [45].
(The Huron) believe there is nothing so suitable as Tobacco to appease the passions; that is why they never attend a council without a pipe or calumet in their mouths. The smoke, they say gives them intelligence, and enables them to see clearly through the most intricate matters [43, p. 2191. Several studies show that memory consolidation can be aided through tobacco use [29,38,40,41]. It would be interesting to explore the premium placed on long term memory in nonliterate cultures without extensive or efficient means of extrasomatic information storage (e.g. books, computers, libraries,
Sociocultural integration
Tobacco possesses both instrumental and expressive value as an integral component of numerous cultural beliefs and practices. It has figured prominently in: secular public ceremonies and sacred rituals (e.g. bridgewealth payments, peace and war pipes, etc.) [48]; religious practices (e.g. prayer and divination, etc.) (491; health and medicinal therapies (such as salves for wounds, as an analgesic and anesthetic, etc.) [SO, 511; Springer [43], for example, lists 32
1346
MICHAELC. ROBBINSand ANNETTEKLINE
sacred and secular uses of tobacco just in the Eastern Native American culture area alone! Socioeconomic
commodity
Tobacco serves as a medium of exchange, luxury good, trade item and cash crop. These economic values and their social ramifications are well recognized in most societies. In sum due to its numerous, unique, inherent attributes working alone, and in concert, tobacco smoking is reasonably selected for the benefits it provides the individual, and in aggregate, the society and culture in (1) enhancing mood, mental state, social behavior and enjoyment of life and (2) coping with negative feelings, stress and physical problems.
stances are used, will assure a deeper, more balanced and hence more usable foundation of knowledge about tobacco use motives, values and behavior. A cross-cultural assessment of both the benefits and risks of tobacco from a decision-making perspective is therefore essential. REFERENCES
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CONCLUSION
Although smoking as a customary behavior is currently becoming outmoded in American society, and is associated with a number of diseases such as lung cancer, chronic lung disease and coronary heart disease [46,47], its use still persists among certain social groups. Some would believe these individuals are ignorant of anti-smoking information or confused by advertising. The overwhelming bulk of evidence suggests however that the populace at all levels is informed about the negative consequences associated with tobacco use, particularly the attendant health risks. They have not only been exposed to this information, they appear to be convinced by it. For example, a 1985 survey indicated that 92% of Americans understood that smoking increases an individual’s risk for emphysema and 95% understood it increased the risk for lung cancer [52]. From the perspective of behavioral decision theory it is obvious that knowledge and beliefs about negative health consequences alone do not govern choice-making. As Loken states: . . a person’s beliefs about the health consequences of smoking need not be the major determinant of smoking behavior. Other negative consequences, such as bad odors or unnecessary expense, and the many positive consequences, such as relaxation, pleasant taste, keeping weight down, or relieving nervous tension may also influence smoking decisions [8, p. 6161. The aforementioned individual and social utilities of tobacco must be considered in any study seeking to explain variation in tobacco use and cessation. That tobacco use is still prominent among certain socioeconomic groups; and that many of these experience powerlessness and occupational stress suggests tobacco can be recruited as a stress reducing, coping mechanism (for the reasons mentioned above). Those who have the most to gain from smoking will undoubtedly choose to continue. Tobacco will thus continue to be used because of its subjectively perceived benefits unless either stress is reduced or acceptable alternatives are found. In the recent past, anthropologists have displayed a reasonable liberalism and objectivity in studying other substances like alcohol [23, 531; coca (54,551; peyote and other hallucinogens [56, 571. Only research such as this, where context, meaning, and form are taken into consideration to determine why sub-
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