Big Nicotine, Part I: Big Tobacco’s Drug Problem

Just over a week ago, the United States Food and Drug Administration announced what new FDA chief Dr. Scott Gottileb called “a cornerstone of our new and more comprehensive approach to effective tobacco regulation”: an initiative to reduce the nicotine content in cigarettes to “minimally or nonaddictive” levels. The 2009 Tobacco Control Act gave FDA authority to reduce any “additives, constituents…, or other component of a tobacco product.”

Obama Tobacco
President Barack Obama signing the Tobacco Control Act

Public health historian Robert Proctor was thrilled. “This is exceptionally good news for tobacco control, and for human health,” he wrote last week in the New York Times. Not so for companies like Altria and British American Tobacco, whose stock value fell within an hour of the statement (and recovered somewhat before the closing bell).

Big Tobacco was reeling for good reason: nicotine is the primary addictive component of cigarette smoking, not incidentally the leading cause of preventable deaths in the U.S. The addictive capacity of nicotine is now practically indisputable. For over sixty years, government regulators, independent researchers, and tobacco company scientists have investigated the extent of that capacity and the danger it poses when delivered via tar-laden cigarettes.Read More »

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Dissertation Roundup: Drug Use and Young People, International Edition

Editor’s note: In today’s post, we highlight a few recent dissertations on drug use among young people from around the world. These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above. Stay tuned for original content, coming soon!

The Development of Health Risk Behaviors by Mexican-Origin Youth

Author: Bacher, Kelly Beaumont

Abstract: This dissertation investigates the development of risky health behaviors by Mexican-origin youth. The two papers comprising this dissertation utilize data from a community sample of Mexican-origin adolescents participating in a prospective, longitudinal research study. Paper 1 examines the longitudinal relationship between ethnic discrimination and adolescent substance use behaviors. This study extends previous work by examining these processes in children of Mexican origin, who are often neglected in research on discrimination. Findings reveal that ethnic discrimination from peers at school predicts increases in substance use across a five-year period of adolescence. Paper 1 also assesses supportive parenting as a source of resilience by investigating potential compensatory and buffering effects on adolescent drug and alcohol use. Paper 2 examines the extent to which, during the transition from late childhood into adolescence, individual and contextual characteristics of female youth predict engagement in risky sexual behavior. This paper addresses a need in the current literature on sexual risk-taking by investigating predictors of this behavior for girls of Mexican origin, who often report higher levels of risky sexual behavior than other ethnic groups. Results indicate that early pubertal development and affiliating with deviant peers are important direct predictors of later sexual behavior. This study also examines indirect and transactional relationships between study variables. Together, these papers enhance our understanding of the family, peer, and personal characteristics of minority children that influence the development of health risk behaviors.Read More »

#ADHS2017 Field Report: Sunday, June 25 by Berrie van der Molen and Lisanne Walma

Editor’s Note: Between June 22 and June 25, the Alcohol and Drugs History Society organized its biennial conference in Utrecht, The Netherlands. In three day-by-day reports, some attendees will reflect upon the proceedings and their highlights.  Today’s post was provided by Drs. Berrie van der Molen and Lisanne Walma. 

“Grass and Grassroots”
By Berrie van der Molen and Lisanne Walma

Despite the rain, and what for some had probably been an intense night of conviviality, a lot of people made sure to turn up for the early Sunday sessions. Their persistence was definitely rewarded as Sunday proved to have a number of essential panels in store at what had already been a very inspiring conference so far! The five panels featured papers taking everyone all over the world and through time: we overheard many attendees finding it difficult to choose from the diverse options.Read More »

#ADHS2017 Field Report: Saturday, June 24 by Kelly Hacker Jones

Editor’s Note: Between June 22 and June 25, the Alcohol and Drugs History Society organized its biennial conference in Utrecht, The Netherlands. In three day-by-day reports, some attendees will reflect upon the proceedings and their highlights.  Today’s post was provided by Dr. Kelly Hacker Jones. 

“On the role of Alcohol and Drugs History”
By Kelly Hacker Jones

In many ways during the recent Alcohol and Drugs History Society meeting in Utrecht, I thought of myself as a tourist. For one, this was my first visit to the Netherlands. For another, this was my first ADHS conference. As a PhD candidate in history studying health and alternative medicine, I come to the history of drugs more from the licit than the illicit side, at least as in terms of my research. The sessions I attended, therefore, were an education in the approaches, methods, and topics of concern for the field. Just as the seasoned traveler will recognize commonalities across cultures, what I observed at ADHS were shared lines of inquiry and familiar challenges.

On Saturday, I attended panels that examined drug cultures, the displaying and depiction of intoxicants, and the interrelationship between drug regulation and industry. From the papers and conversations I heard, I learned a great deal about the contexts in which various substances have been traded, taken, and regulated. A common area of inquiry I observed was that of the public’s perception of drugs. Convincing the public to think one thing or another about various substances seems to have occupied a great deal of the time, money, and effort of governments and manufacturers across eras and countries.

The keynote address by ADHS President Virginia Berridge, “Where is Alcohol and Drugs History Now?” gave an overview of the development of the field. In the last couple of decades it has gotten more diverse geographically (beyond the US and UK), chronologically (into the early modern period), and topically (substances beyond opium, cocaine, and cannabis). Professor Berridge also posed questions that have been plaguing historians across the discipline. How might we engage more across fields? And what role should historians have in the areas of policy, public health, and addiction studies? Should we strive to make a direct impact, or think of our scholarship as “seeping” into the public discourse on intoxicants, effecting indirect change?

The open forum pounced on this latter question. Where do historians fit in? Many picked up on the theme of seepage, asserting that we can best effect change indirectly through teaching and scholarship. Others stressed that scholars should take a more direct approach and try to inject nuance and context into debates, whether in policy, popular media, or in the courtroom. Yet in all arenas, the demand seems to be for uncomplicated, definitive answers. How can historians inject nuance and context when news media, policy makers, and the public seem to prefer convenient, easy-to-swallow sound bites?

I’m thinking about all of this after I’ve returned home, and I’m preparing to give a walking tour on the local history of Prohibition – a tour I’ve given dozens of times. It’s a difficult one to wrap up, as the tour meanders through sites connected to both the politics of Prohibition and to speakeasy culture. What I talk about most, however, are the attitudes influential groups and individuals had about the use and abuse of alcohol over the course of nearly a century. And I admit, I’ve been cautious in recent months about appearing to favor one side or the other in the controversies I discuss. But what I should be doing, I realize, is emphasize how the conversation about alcohol changed during this era, and what that meant for public policy. That, to me, now seems the most important lesson of Prohibition.

#ADHS2017 Field Reports: Friday, June 23 by Richard Robinson

Editor’s Note: Between June 22 and June 25, the Alcohol and Drugs History Society organized its biennial conference in Utrecht, The Netherlands. In three day-by-day reports, some attendees will reflect upon the proceedings and their highlights.  Today’s post was provided by Richard Robinson, urban historian at the University of Helsinki.

“The interdisciplinary spirit of enthusiastic curiosity in classrooms doubling up as impromptu saunas”
By Richard Robinson

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At 8.45 AM on a fine Friday morning, the opening sessions of the Alcohol and Drugs History Society conference feel very far away indeed. Our party has left its hotel on the outskirts of Utrecht to walk to the university, but we have naively strolled straight onto a bike superhighway during rush hour. This is no place for the humble pedestrian: hundreds of cyclists stream past as we stumble along the grass verge, scouring the foliage in vain for an exit route. The sole geographer in our party is visibly flummoxed, and the day’s panels disappear in a whirl of spokes and fixed gears. Our destiny, it seems, is to be a very Dutch form of road kill.

Thankfully, two English literature scholars emerged as the unlikely heroes, navigating us successfully over a two-tiered canal to the comparative safety of a residential road. Breathing a sigh of relief, the one thing I really needed at that moment was a strong drink-and-drugs-themed conference. Luckily, Friday’s papers did not disappoint: fascinating new research was introduced and old narratives were undermined in an atmosphere that exuded bonhomie and warmth, a result of both an interdisciplinary spirit of enthusiastic curiosity and classrooms that doubled up as impromptu saunas.

Given the subject matter and conference title, it is perhaps redundant to observe that regulation was one of the recurring themes of the day, but those presentations that considered its porosity and cultural form were particularly enlightening. Focusing on seventeenth-century England, Alex Taylor adeptly demonstrated how the illicit trade in bulk tobacco by the very sailors responsible for its transportation meant that attempts to license and restrict the good largely went up in smoke. Ryosuke Yokoe traced the shifting medical conception of cirrhosis in Britain – from alcoholic’s disease in the Edwardian period to a consequence of poor nutrition in the 1940s – and argued convincingly that this was due to a softening of the political climate surrounding drink. Finally, Rachel McErlain considered the soft regulation of moral suasion, immersing the audience in the melodramas of mid-nineteenth-century temperance tracts and assessing the ways in which they depicted drinking as anathema to feminine respectability.

McErlain’s paper was also one of a clutch that addressed the significant roles of women in drink history: as victims, as sellers and as reformers. Showing that a lack of extant source material does not preclude comprehensive analysis, Jenni Lares used lower court records and Judith Bennett’s seminal work on England to examine the status and rights of female publicans in early modern Finland. Victoria Afanasyeva discussed the increasing prominence of women in the French temperance movement from the late nineteenth century, and reminded us that such campaigns did gain traction in countries beyond the traditional temperance cultures.

Indeed, throughout the day established truths of drink history were called into question. Richard Yntema’s meticulous account of the development of the distilling industry in Holland went against the grain of conventional wisdom by demonstrating that spirits were being commercially produced already in the late sixteenth century. In her expansive discussion of transatlantic temperance connections, Annemarie McAllister stressed that, in spite of the two-way cultural transfer that clearly took place, the British movement always remained on the fringes of mainstream society, in contrast to its US counterpart. And in the keynote lecture, Phil Withington confronted his 2010 economic-history-seminar demons in style, roundly – or perhaps rather trigonally – disabusing the notion that per capita consumption should be the pre-eminent means of understanding intoxicant use. Railing, too, against presentist historiography, and drawing on theory by Elizabeth Shove, amongst others, he outlined the premise of his multidisciplinary consumption triangle, which puts the study of the production, control and representation of social practice firmly at the palpitating heart of alcohol and drug history.

Post-plenary, it was resolved to put social practice theory to the test, and we meandered along the riverside into a park for a Dutch festival. Unlike Dutch courage and Dutch uncles, it should be noted that this is intended as an entirely positive epithet: not every country can combine large-scale public drinking and good cheer so easily. With pockets full of munten (a cardboard currency of indeterminate value) and power in numbers, we occupied a coveted picnic table and began to explore the multitude of food stalls and beer tents in the vicinity. Sadly, I was not party to the astonishing debauchery that no doubt occurred as the night progressed: ever the professional, I left early to prepare for my presentation. However, lacking the advanced orientation skills of literary scholars, I proceeded to finish the day as I began it, by getting hopelessly lost.

 

Recent Publications in Contemporary Drug Problems: Withdrawal and Maintenance

Editor’s Note: Frequent readers may be familiar with the blog’s ongoing promotion of new, relevant dissertation research, but periodically we also highlight work published in journals and other peer-reviewed outlets. Each of the articles below appeared in recent issues of the journal Contemporary Drug Problems, concerning drug withdrawals, substitution, and maintenance. All titles contain links to the respective articles. Enjoy!

Addiction, Drugs, and Experimentation: Methadone Maintenance Treatment Between “In Here” and “Out There” (2015)

Bjarke Nielsen, Esben Houborg

Abstract: In Denmark, outpatient substitution treatment has traditionally been associated with a great deal of ambivalence and control. Until the late 1990s, a condition for entering substitution treatment was that the user ceased using illicit drugs. Failure to comply would in many cases mean expulsion from treatment. However, since the late 1990s/early 2000s, a more liberal substitution treatment policy has developed, which recognizes continued attachments to illicit drugs and drug scenes for many drug users. With this shift in treatment rationality, treatment encounters between social workers and drug users can be analyzed as experiments enacting new relations between legal and illegal drugs, bodies, and environments. Drawing analytical inspiration from material semiotics and actor-network theory, this article focuses on how “outside” relations are articulated and become visible “inside” outpatient treatment encounters. Against this backdrop, we analyze the trial and error involved in stabilization as a set of ongoing processes relating to configurations of heterogeneous material networks. The article presents by way of a case study a detailed analysis of these entanglements, drawing on data from two qualitative studies of outpatient substitution treatment in Denmark.

Opiate Substitution Treatment: Poisoned Bodies and the History of Substitution (2013)

Ian WalmsleyRead More »

New Research on Drugs and U.S. College Students

Editor’s note: In today’s post, we highlight a few recent dissertations on drug use among college students and its regulation by authorities. These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

E-Cigarette Adoption and Use Intention Among College Students: Determinants and Warning Label Effects

Author: Lee, Hsiao-Yun

Abstract: The electronic nicotine delivery system (also known as the e-cigarette) is a recently-invented battery-operated device that mimics smoking by delivering nicotine without burning tobacco. Without governmental regulation, the e-cigarette has been heavily promoted in the United States (US) and have aroused a vigorous debate over its health effects. Supporters believe that the e-cigarette is a safer alternative for smokers because it does not contain toxicants such as tar and carbon monoxide, while opponents are concerned that e-cigarettes will re-normalize smoking behavior and may serve as a gateway to traditional cigarettes. According to a national report, the percentage of use of non-traditional tobacco products is increasing among college students, implying that more college students are at risk of being addicted to nicotine. Previous studies also show that this age group has the highest rate of ever-use e-cigarettes, indicating an urgent need to investigate college students’ e-cigarette use. Because e-cigarettes are not currently regulated by the US Food and Drug Administration (FDA), manufacturers are not obligated to include warning labels on their packages. Nevertheless, some e-cigarette companies have created their own warning labels without examining their effects. This study consists of two sub-studies. Sub-study 1 investigated college students’ e-cigarette use by examining differences in characteristics at different e-cigarette adoption levels based on the Diffusion of Innovation Theory. Sub-study 2 aimed to investigate the effect of e-cigarette warning labels on college students’ intention to use e-cigarettes by examining two warning labels, one generated by the FDA and one by e-cigarette companies. A total of 1,198 undergraduate college students at a Midwestern university, aged eighteen to twenty-five, were surveyed in September and October 2015. Multinomial logistic regression and Heckman two-step selection procedures were conducted to examine the influence of determinants on levels of e-cigarette adoption and transition. Structural equation modeling analyses were implemented to examine the effect of warning labels on college students’ intention to use e-cigarettes. The findings of this study show that e-cigarette users are more likely to be current substance users and that flavor is a strong factor inducing college students to use e-cigarettes. Rather than seeking to reduce stress, college students use e-cigarettes for positive sensory experiences and care more about their appearance than their health. Regarding warning label effects, the warning label proposed by the FDA was found to reduce college students’ intention to use e-cigarettes via increasing their perceived risk of e-cigarette use. The FDA warning is more effective than the warning label created by e-cigarette companies. The resultant findings not only could be used as references for future e-cigarette regulations and interventions, but also could serve as direct evidence for establishing future mandates, including the regulations of label content and design.Read More »

The Points Interview: Jane T. Merritt

Dr. Jane T. Merritt is an associate professor of history at Old Dominion University and author of the new book, The Trouble with Tea: The Politics of Consumption in the Eighteenth-Century Global Economy (Johns Hopkins, 2016).

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Describe your book in terms your bartender could understand.

The Trouble with Tea explores 18th century consumer culture, market economies, and their political use and meaning.  The core of the book’s argument questions the old adage among economic historians that consumer demand drove merchants to provide an ever-increasing supply of goods, thus sparking a Consumer Revolution in the early eighteenth century.  Tea presents a different picture.  Instead, political concerns about the domination of Britain in a global economy and the corporate machinations of the English East India Company (EIC) in the 1720s and 1730s produced an over-supply of Chinese tea that the Company then funneled to North America, hoping to find a market.  American consumers only slowly habituated themselves to the beverage, aided by the availability of Caribbean sugar.  Still, American merchants and consumers took to tea by mid-century, even as colonial activists called for a boycott of British goods.  Boston wasn’t the only place that held a “Tea Party” to protest imperial tax policy in late 1773.  Citizens of Philadelphia, New York, Edenton, North Carolina, and Charleston also destroyed or forcibly returned the EIC tea commissioned for sale in North America.  In truth, however, Americans did not reject luxury consumption or tea; they simply wanted quicker, easier access to foreign commercial markets, which they returned to soon after the American Revolution.  Ironically, individual states and the new federal government established under the 1787 constitution revived taxes and tariffs on tea as a key source of revenue.  Creating, then fulfilling consumer desires, has always been a driving force in the American economy.Read More »

#ADHS2017: Utrecht, The Netherlands

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The Alcohol and Drugs History Society convenes this weekend at Utrecht University in the Netherlands for its biennial meeting.  The conference theme is “Drinking and Drug Policies in History: Contextualizing Causes and Consequences.” There, participants are presenting new research and charting the future of the field. In an opening keynote address delivered Friday evening, “The Consumption of Intoxicants in the Past – Old Problems, New Approaches,” Phil Withington suggested innovative methodologies to make sense of how and why people – and, importantly, which people – used intoxicants in the past. (Also be sure to check out Dr. Withington’s Intoxicant Project for more information on drug use in early modern Europe.)Read More »