accounting for smoking, relating to the respondents' occupational backgrounds. Contrary to ..... coded and analysed with the help of Atlas.ti software.
Sociology of Health & Illness Vol. 32 No. 7 2010 ISSN 0141–9889, pp. 1087–1101 doi: 10.1111/j.1467-9566.2010.01267.x
Social class differences in the accounts of smoking – striving for distinction? Anu Katainen Department of Sociology, University of Helsinki, Finland
Abstract
The dominant trend in smoking prevalence in most Western countries is its increasing association with lower socioeconomic positions, making it a major factor behind inequalities in health. This paper focuses on the reasoning behind smoking, as well as on its social significance among middle-class and workingclass smokers. The data consist of 55 semi-structured interviews with daily smokers, ex-smokers and occasional smokers from different occupational backgrounds. The analysis revealed considerable differences in the ways of accounting for smoking, relating to the respondents’ occupational backgrounds. Contrary to expectations, non-manual workers tended to consider their smoking functional, pleasurable and controlled, whereas the opposite was the case with the manual workers. Despite the high prevalence of smoking in that group, they were least willing to justify or rationalise their behaviour, whereas the agenda of middle-class smokers could be interpreted as the reconciliation of middle-class habitus with a risky, working-class habit.
Keywords: smoking, social class, health behaviour, reflexivity
Introduction An extensive amount of research has demonstrated the association between health status and social class. It is well known that the most severe risks tend to accumulate in lower classes and that middle and upper classes are more likely to enjoy long and healthy lives (Lynch et al. 1997). While the factors behind health differentials are numerous and interact with each other, the actual behaviour and daily choices – how much people drink, smoke, eat and exercise – counts a great deal in generating differences between social classes. Accordingly, class differences in health also imply differences in lifestyles. Although social class is one of the key variables in epidemiological health research, at the same time there has been a discussion within social sciences on whether the concept of class is outdated in terms of analysing highly differentiated, late-modern societies characterised by cultural and social heterogeneity (i.e. Pakulski and Waters 1996). In the discussions on individualisation in late-modern, reflexive societies, construction of identities and personal lifecourses is seen as disentangled from old traditions and social categories such as class (Beck 2000). However, smoking – while being a major public-health issue – is a good indication of the continuing importance of class. The dominant trend in smoking prevalence in most Western countries is its increasing association with lower socioeconomic groups, 2010 The Author. Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd. Published by Blackwell Publishing Ltd., 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA
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making it a major factor behind inequalities in health (Jarvis and Wardle 2006). People in such groups are more likely to smoke daily, smoke more and to be less likely to quit (Flint and Novotny 1997, Jeffries et al. 2004). Because of the extensive public-health costs associated with it, smoking is nowadays framed primarily as a health issue. Unfortunately, this has in many ways led to a narrowing understanding of smoking as part of our daily practices, and especially of its current cultural status. Moreover, many researchers have repeatedly argued for a wider perspective on people’s daily lives, meaning that people’s own experiences of health and illness should be taken into account in the research of socioeconomic health differentials (Chamberlain 1997). The present study aims to further the qualitative research tradition on the links between health and social class by examining accounts of smoking in two groups of daily smokers, namely manual and non-manual workers. While many earlier studies have addressed the cultural and social meanings of smoking and its varying roles in everyday life (e.g. Bancroft et al. 2003, Stead et al. 2001, Laurier et al. 2000), the main interest here is in the differences in account strategies between the two groups. This is not to say that the study of accounts would give an ultimate explanation for socioeconomic differentiation smoking. However, meanings are important in the sense that they reflect and reinforce the differentiation through definitions of the appropriateness of smoking to certain groups, contexts and situations. With the help of Pierre Bourdieu’s ideas of habitus and reflexivity, the aim is to connect smoking with the strategies of distinction and to examine meanings of smoking in various work contexts.
Social class, health behaviour and reflexivity There has been a steady increase in knowledge about the health consequences of smoking in recent decades. Against this background, it has been suggested that what explains the social differentiation of smoking is simply the fact that educated people are more interested in health matters and are accordingly more motivated to give up smoking. Although previous qualitative studies on class and health have shown that health is considered equally important by all social groups, the ways of acting accordingly seem to differ. The upper classes tend to consider health a norm in itself, something that needs to be achieved and against which daily practices are reflected (d’Houtaud and Field 1984, Calnan and Williams 1991). Typical of the lower classes, on the other hand, is to view health as something practical, as a means enabling daily routines (1984, 1991). It is however important to note that studies on health behaviour may easily overestimate the significance of conscious health considerations in everyday life (Calnan and Williams 1991). Many habits that health research terms ‘health behaviour’ are not necessarily considered health related in everyday life, and are more likely to be governed by routines, cultural patterns and social practices than by conscious efforts to improve one’s health (Williams 1995). Explaining smoking and other risky habits thus raises fundamental questions about human behaviour. To what extent is our behaviour guided by deeply rooted habits of which we are not aware? In what kind of situations are reflexivity and the questioning of habits – possibly leading to changing them – brought into play? In this context, Bourdieu’s concept of habitus appears to be very useful in studying class differences in smoking, as well as in other forms of health behaviour (Williams 1995). Bourdieu used the concept to illustrate that practices and habits people have are not simply a consequence of individuals’ conscious choices, and not just products of social structures of which they are unaware. Constituted of individuals’ living conditions, habitus is an 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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internalised disposition that generates certain practices, orientations and forms of classification (Bourdieu 1984: 101, 170–2). It offers a class-based way of classifying and interpreting the social world and ways of operating in it. Moreover, for the different social groups, it serves as a mutual frame of interpretation through which action becomes intelligible, based on shared living conditions and life events. Through habitus, living conditions affect peoples’ choices and behaviour regarding the options that are possible and considered appropriate ‘for people like me’ (cf. Lynch et al. 1997). What is relevant is that we do not constantly choose what our food preferences are, for instance, but our preferences reflect our social background (Sweetman 2003). Illustrative of the connection between different kinds of habituses and habits are images of a truck driver eating heavy, fatty meals and a young white-collar woman preferring a light salad: the appropriateness of certain habits is related to the individual’s social position. In this sense, smoking could today be considered a cultural practice rooted more in a working-class habitus, and is thus rarely questioned and reflected on in various working-class contexts. The concept of habitus is often criticised for being overly deterministic. It has been pointed out that people are probably more aware of the rules and determinants of social life than Bourdieu seemed to assume. For Bourdieu, action has its reasons, but people are just not aware of them (Jenkins 1992). He may also have underestimated the dynamics and reflexivity of lifestyles in post-traditional societies and consumer cultures (Archer 2005). However, Bourdieu does leave space for choice and conscious consideration. In accordance with pragmatist views on action (Kilpinen 2009), reflexivity takes place in situations of crisis, in which the adjustment of the habitus to the field is disrupted (Bourdieu 1990: 108). In other words, the habits of everyday life tend to go largely unnoticed until a personal or social crisis brings them out, opening up the possibility for conscious deliberation and rational choice (Crossley 2001: 113, Bourdieu and Wacquant 1992: 131). As Nick Crossley (2001: 113–14) has noted, there is no contradiction between habitus and reflexivity as such. Rather, in order to be reflective, behaviour needs to be rooted in pre-reflective habits. This kind of habitual perspective is a challenge in qualitative research on health behaviour, however. First of all, accounts for certain behaviour given in interviews cannot be considered reasons for behaviour as such. As Bourdieu (1977: 18) argued, people cannot be aware of all the factors affecting their behaviour, nor of the implicit logic behind it. However, although the logic of practices lies outside conscious choice and discourse, this is not to claim that action could not be consciously motivated (Williams 1995). What is relevant is that habits need to be compatible with the context and the external conditions of action, as well as with one’s habitus. Through reflexivity it becomes possible to rationalise these relations, meaning that accounting for one’s behaviour always contains a strategic element. The smoking habit is likely to be often under reflection due to the associated health risks, but health is not the only factor. Drawing on Bourdieu, it is likely that it is not only health concerns, but also the accumulation of smoking in lower social classes that has made it more inconsistent with a middle-class habitus. Accordingly, it is not primarily some ideal of health that makes people reflect on or change their habits, but rather the idea of one’s position on a social map and what is considered ‘good’ and valuable in certain contexts. As Beverley Skeggs (2004: 141) has noted, the social meaning of a practice, its value, and its ability to signify social distance do not derive from some intrinsic property of the practice, but from the position it has in the system of objects and practices. Producing and maintaining class distinctions is about knowing the cultural reference points of one’s preferences and habits and how to play with them. Therefore the important thing is not just obtaining objects and knowing how to use them, but also, the way of conceptualising them in relation to others. Consequently, health-related accounts are not only personal ideas of one’s 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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behaviour, but through them people are actively negotiating their place in the world, as well as constructing and maintaining their social identities (Herzlich 1973, Radley and Billig 1996).
Data and methods The present study is part of a joint research project by the University of Helsinki, and the National Public Health Institute (2005–2008) focusing on the cultural and social aspects of smoking. The data consist of 55 semi-structured interviews with daily smokers, ex-smokers and occasional smokers aged between 24 and 58 (see Table 1). The participants were recruited in 2006–2007 from 14 companies and organisations located in several cities in Finland (Helsinki, Tampere, Turku and Varkaus). The companies were chosen in order to find smokers from diverse work environments. The respondents’ occupations varied from construction and warehouse work to secretaries, consultants, lawyers and managers. Except for two, the interviews were conducted with the permission of the employer during working hours and they ranged in duration from 30 to 90 minutes. The interviews were conducted by two female researchers in their late twenties1. Non-manual workers were contacted through companies’ intranets and with manual workers several contact persons in the companies invited smokers to participate. In addition, the snowball method was utilised in both groups. With non-manual workers the interview situation was relaxed, and respondents seemed very willing to share their thoughts, whereas with manual workers the situation was occasionally more tense. Some male respondents seemed somewhat timid in the presence of a young female researcher, which may have affected the ways the respondents expressed themselves. The interviews covered two main themes: actual smoking behaviour including the number of cigarettes smoked daily, smoking situations, smoking practices, and social contexts, and on the other hand the meanings attributed to smoking. The interview questions thus included simple questions covering daily smoking behaviour at home and work, and more tricky ones aimed at revealing the meanings and ‘unwritten rules’ of smoking. All interviews were recorded and transcribed. The research plan for the interviews was approved by the ethics committee of the National Public Health Institute. and good research practice guidelines were followed (National Public Health Institute 2006). All quotes used in this article were translated into English as accurately as possible, and pseudonyms are used in order to protect the anonymity of the respondents. The aim of the analysis was to understand how smokers from different occupational backgrounds reflected on their smoking. The analysis concentrated on daily smokers’ accounts through which smoking was made intelligible (Radley and Billig 1996, Scott and
Table 1 Sample members Non-manual workers Daily smokers Male Female
9 9
Occasional smokers 1 1
manual workers Exsmokers 7 4
Daily smokers 9 9
Occasional smokers 1
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Exsmokers 3 1
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Lyman 1968). Reflexivity on the habit means that attention is paid to the conditions, reasons and constraints of action in a situation in which the habit is for some reason confronted with a crisis (Kilpinen 2009). It is worth noting that the interview situation itself puts the smoking habit into a crisis, since in the interview the respondents are compelled to give accounts, and thus reflect on their habit. As has been shown in previous studies, there are several commonly shared presuppositions concerning the nature of tobacco addiction. Smokers may consider their smoking a choice and emphasise positive and play down negative aspects of it, or a dependency, thus denying the responsibility of their smoking (Gillies and Willig 1997, Coxhead and Rhodes 2006). In their classic paper, Scott and Lyman (1968) described these two types of accounts as justifications and excuses, the former explaining the action by denying the negative quality of it and the latter by denying full responsibility. In the analysis the focus was on these two types of accounts and how they were used in the two groups under scrutiny. The data were coded and analysed with the help of Atlas.ti software. Justifications of smoking included two subgroups of codes relating to the positive functions of smoking and expressions of selfcontrol and will. Excuses included accounts in which smoking was explained by factors such as dependency and by external factors that made respondents unable to give up. This division of accounts turned out to be relevant regarding the differences between manual and nonmanual workers. On the other hand, it is equally notable that the differences between the classes were not clear cut. The aim in the following analysis is to highlight the basic features of the accounts of smoking in the two groups – the logic of legitimisation among the nonmanual respondents and the lack of justifications among the manual workers.
Results A controlled pleasure of the middle class? A distinctive feature in the non-manual smokers’ accounts was the description of pleasurable and unforgettable smoking experiences. Smoking was considered an integral part of daily life, but it was also a way of marking special occasions. Memorable smoking experiences occurred on a sailing boat when the sun was going down, when confronted with a spectacular view, after climbing a mountain, and – in a particularly Finnish manner – after a sauna at the summer house with a glass of wine or beer. When the question about the positive aspects of smoking was posed, it was typical for the respondents first to hesitate, but then to give vivid descriptions: Int: Yeah… you already said that it brings comfort and helps in certain situations, but what else? What is good about smoking? R5: Well actually there’s hardly anything good about it. But maybe it’s like a little drop of… like the final touch at some wonderful moments, like when it’s a summer night and you are sitting by the lake, it is still and warm, no mosquitoes, a little breath of wind, and you sit there, in good company, probably having a beer, you feel good just being there, and then you have a smoke. If you don’t have it, it feels as if something’s missing. (45-year-old female, controller). Typically, the descriptions of pleasurable smoking referred to private occasions without other people around. Although smoking is generally considered a social addiction, what was emphasised in the accounts was individuality. Although the respondents appreciated smoking in good company, it was described as a private, individual habit, which was not dependent on 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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cues, such as workmates who smoked. As Riitta, a 44-year-old CEO’s assistant pointed out, the right time for smoking was when it suited her and her work best: Int: Who are you usually with when you smoke at work? R17: Just with whoever happens to be there… I know that many people have a kind of a gang of people to smoke with, but I’ve never really liked that. I like to do things on my own, go my own way. I go when it’s a good moment. It’s the same thing with coffee breaks, as I don’t want any routine because that would only mean that you’re sitting there longer and that sort of thing, so I go when I’ve got my work done, when it’s a good time for a break. So I may as well, and mostly I do, almost always I go by myself, alone. So it depends on who happens to be there. (44-year-old female, assistant) Individuality also came up in other ways among the white-collar respondents. One of the aims in the interview was to find out how smokers classified themselves as smokers. Several questions concerned the images the respondents had of typical smokers. However, they found it very hard to describe or categorise them: Int: Do you have any thoughts about what kind of people smoke? R1: Actually I don’t… Who are the smokers… Well, there are fewer and fewer of them these days, but… Int: But you don’t have any images of those who still smoke? R1: What kinds of groups of people? No, no I don’t. Int: You don’t, for example, notice that there are certain people that… R1: No, not as such, I can’t say that there’s a certain group, but let’s say there are certain situations, typically in a bar, where people smoke, even those who don’t normally smoke. But I can’t say because I don’t know… quite hard to answer this question. (34-year-old male, lawyer) The respondents were highly cautious in making any generalisations or bringing out stereotypes. This was somewhat surprising, given the fact that smoking is constantly related to a variety of symbolic meanings in popular culture and media. The respondents attributed hardly any qualities to smokers, and above all, they did not associate themselves with any social groupings due to smoking. Smoking was discussed mainly as an individual habit without any shared symbolism. What was particularly significant was that no class distinctions were made in the interviews. Consequently, no explicit smoking-related class consciousness was evident. Only a couple of respondents mentioned the association between low education and smoking, but this fact was not reflected in the respondents’ own smoking. Although the question about social divisions related to smoking seemed to be difficult to answer, it did not mean that there were no distinctions made at all. They were made in more subtle ways, not between social groups but in relation to smoking habits. For instance, smoking in a smoking room at the workplace was experienced as unpleasant, but this was not only due to the atmosphere, as Pekka, a 34-year-old lawyer, described: But I, for example, think that I smoke less than many of those included in this 15 per cent (the participant’s estimation of the proportion of smokers at his workplace), and that for some people it’s a sort of compulsion, a kind of physical need to have a smoke every hour, so it (the smoking room) serves them very well. Considering that even if it’s raining you 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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can go there, but for me, if it’s raining, I don’t go for a smoke. I just don’t go at all and I wait until the rain stops. (R1: 34-year-old male, lawyer) In the quotation the respondent differentiates himself from other smokers by referring to his ability to control his smoking. For him, smoking was not a question of addiction or routine, as he assumed it was for his workmates, it was a voluntary act. A strong feature in the interviews with white-collar workers was the distinction between functional smoking and smoking as a routine. Smoking was experienced as acceptable when every cigarette had a function – relaxation or fostering new ideas, for instance – and when it fitted the situation. Tapani, a 44-year-old executive director, also emphasised self-control: Int: So what are the situations in which smoking is not appropriate? R22: Yeah, in some ways the impatience in certain situations, like if there’s something going on, a christening or something, something important, and then someone suggests a cigarette break, so it feels like, wait a minute, this doesn’t make any sense. I mean people should be able to control their drives at least to some extent… (44year-old male, executive director) Smoking was perceived as being guided by many rules that defined the purpose of a certain situation. Acceptable smoking was defined against unacceptable behaviour. Only two of the white-collar interviewees had a very negative attitude towards their own smoking, but interestingly, they also shared the focal feature of the white-collar accounts, an emphasis on self-control, as exemplified in the following account by Tuomas, a 39-year-old programmer: Int: Now that there are more and more smoking restrictions and you said earlier that you preferred non-smoking restaurants…? R8: Yes, I wholeheartedly support the protection of people who are trying to get away from it. I would assume… I’m the kind of smoker that… first of all, I never smoke inside a car, and I don’t smoke inside generally, and I don’t like being in a room or in a restaurant where there’s lots of smoke. There’s that smell all around. Because, for example, the thing about my smoking is that I taste it when I smoke, so it’s just as bad a smell for me as it is for those who have never smoked. (39-year-old male, programmer) Tuomas makes a distinction between himself and other smokers by highlighting his personal rules and emphasising his ability to ‘taste’ every cigarette he smokes. By tasting he means that he is aware of his own smoking. It is not something that just happens, but a conscious act. Moreover, for the white-collar interviewees, smoking was also an issue of personal style, as for Tuula, 46-year-old system manager: Int: What do you think, are there some situations in which smoking isn’t appropriate? R31: I don’t know…Well, kind of formal occasions maybe. Once, an estate agent came into our place straight after smoking outside on the doorstep and smelled really bad and that, so it gives kind of a nervous and messy image, even though you know that it isn’t necessarily like that at all. Int: Why do you get that kind of image? R31: Well it could be the smell, especially if you smoke outside, maybe on a rainy day and you come in straight away without having a pastel or anything, so the smell is quite unpleasant. And maybe it’s like… I don’t smoke in that kind of situation, if I’m walking to the bus stop or something. I have to stop and take it easy, it gives me a 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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nervous feeling if I see somebody getting out of the car, lighting a cigarette and inhaling five times before going to the supermarket. That’s the kind of smoking I don’t… it’s not my style. (46-year-old female, system manager) The above quotation sums up the basic features of middle-class smoking: it needs to have its own time and place so that it does not interrupt other daily routines. Restricting acceptable smoking only to certain moments implies that smoking in a hurry, while walking or on other unspecified occasions, was perceived as an inability to control one’s smoking. When the respondents described their own smoking as functional and as something that they deliberately assigned to certain occasions, they simultaneously implied that it was controlled. For them, smoking was a question of choice, not of dependency. Hence, it was not smoking as such that was presented as a negative thing, only the forms of it that seemed to question self-management. The respondents described how they had tried to stop when smoking no longer seemed to make sense. Accordingly, when Tuula’s smoking had become more of a routine, she was more motivated to stop: Int: Would you like to quit smoking? R31: Yes. But then again… Int: But then again… [laughs]! R31: [laughs] I don’t know if I want to quit but I would like to have a longer break from smoking. Int: Why? R31: It’s because… I don’t know where it comes from, but you somehow get tired of it. When I started to smoke again after a break it was really so much fun, really like my own thing, that I smoked a little, but now it’s again more like a routine. And anyway it’s not so often that you actually enjoy it. There’re those cigarettes, for example after a meal, when you really concentrate on it, like now I’m having this one and it’s completely OK. But then you can easily just have a smoke without even realising it, while chatting or speaking on the phone and you just smoke then. So it isn’t worth it. (46-year-old female, system manager) A crisis situation among white-collar smokers thus seems to occur when smoking becomes so strongly entrenched as a routine that it is difficult to perceive (or present) it as an act of free will. Resolution could be in the form of justification – for example by drawing a line between acceptable and unacceptable smoking. The accounts of smoking given by the respondents in this group were characterised by references to the appropriateness of their own smoking as distinct from ‘other people’s’ compulsive and dependent smoking. As Bourdieu (1984: 56) famously noted, ‘tastes are perhaps first and foremost distastes, disgust provoked by horror or visceral intolerance (‘sick-making’) of the tastes of others’. For the middle-class respondents, such a denial, even disgust, was directed towards the inability to control one’s appetites (cf. Michelle Lamont (1992) for similar findings with regard to the American and French upper middle class). A dependency of the working class? At the beginning of the research it was expected that the most positive comments about smoking would come from the manual workers. From what is known about the present-day stratification of smoking, they were assumed to be proud and ‘resistant’ smokers, associating the habit with rebelliousness and independence. This was not the case, at least not explicitly. It was also expected that smoking would have been presented as functional, especially in the 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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work context. According to the respondents, smoking served as a way of legitimising and prolonging breaks. The most often mentioned positive effect of smoking was relaxation, as Antti, 34-year-old construction worker describes: Int: What kinds of good things does it bring? R49: Well nothing [laughs] Int: Nothing? R49: Nothing [laughs]. I can’t think of anything, anything good. Well could it be some sort of… well I guess it’s kind of a pleasure when you have a fag when something really pisses you off. Hard to say if it’s any good though. Maybe it’s kind of a pleasure sometimes, that’s all. (34-year-old male, construction worker) Antti associates the pleasure of smoking with moments when ‘something really pisses you off’. In addition, respondents told how stress and anxiety increased smoking. Other positive aspects were the sociability of smoking, especially on breaks, and how smoking made it easier to get to know other workers. The combination of coffee and cigarette was for most respondents the moment when smoking was enjoyable. Although smoking was associated with quite similar positive aspects both among manual and non-manual workers, the essential difference was how these aspects were brought out in the interview. In general, manual workers emphasised the negative effects of smoking and concerns about health risks. For this reason, discussion about positive aspects was experienced as difficult, as was the case in the previous quote. At their most negative, manual workers assigned virtually no positive role or meaning to smoking and in their responses they did not have much to say about it. The most revealing question in terms of the differences between the non-manual and manual workers was ‘Why do you smoke?’: R50: That’s a good question [laughs]! I don’t know. It’s just a bad habit. I don’t have anything wise to say about it. Int: Don’t you think there’s anything positive in smoking? R50: Well I haven’t found anything positive yet. I can’t think what could be positive about it. (39-year-old male, construction worker) Int: Why do you smoke? R54: Because I’m dependent on nicotine. It’s as simple as that. It’s a habit. (27-year-old female, construction worker) ‘It’s just a bad habit’ was the most typical form of explanation among the blue-collar workers. It was considered almost universally a bad thing, with no rationalisation or justification. Whereas the white-collar group described pleasurable smoking experiences in detail, the blue-collar interviewees found it difficult to say anything good about it: Int: Do you think there’s something positive about smoking? R45: There’s nothing good in it. Just the opposite, it has only bad effects… I don’t know. You’ve just been smoking for such a long time. Would it be hard to quit, I don’t know. I’ve never tried. (58-year-old female, warehouse worker) Int: Do you think there’s something good in smoking? R46: No. Int: Don’t you think it’s fun? 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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R46: No, it even tastes bad. Int: [laughs] But what about during the breaks, isn’t it somehow a pleasant thing to do? R46: Well it’s a sort of… for example after coffee and so on, then it tastes good, but in the end you can’t find anything good about it. You just ruin your health and lose your money. (24-year-old male, construction worker) In the first quote, the respondent associates smoking exclusively with disadvantages and excuses it by referring to her long history as a smoker. Smoking is reduced only to a habit, and even though the respondent brings out the negative side, she mentions that she has never tried to give it up. Interestingly, the respondent does not try to justify the apparent contradiction. Smoking is not legitimised, but it is excused by the long continuance. In the latter quote the respondent denies that smoking could be related to anything positive, but names the combination of coffee and cigarette when asked again. However, despite the fact that the respondent mentions a positive aspect, it is not used as a justification for smoking; it is not ‘the final touch of wonderful moments’, for instance, without which something would be missing, as the controller Riitta described above. How did manual workers account for their smoking? In the accounts of non-manual workers, the justifications were emphasised, but with the manual workers a more important way of accounting was giving excuses. Smoking was typically explained by a dependency, a habit, or by external factors such as stress caused by work or hardship in private life. Anssi, a 46-year-old construction worker, experienced his smoking mainly as an addictive habit that was an integral part of certain daily situations and acts: Int: So, why do you smoke? R51: It’s a bad habit. Such a bad habit. It just goes with some… Coffee… I’ve quite a craving already – Well not that, but a habit, I should go soon since I’ve already had coffee. After a meal. If I’m driving with someone who doesn’t smoke I really respect that so I don’t smoke inside a car. But when you are driving alone… smoke, smoke (acts smoking). So it’s just… I consider it a bad habit. (46-year-old male, construction worker) Many of the interviewees expressed their frustration about the habit, as Antti, 34-year-old carpenter, said: ‘It really pisses me off that it’s just smoking there [in his mouth] all the time (R49)’. Interestingly, smoking was almost always described in the passive form: it was something that just happened without being consciously desired. The same feature is also present in the interview with Arto, a 56-year-old construction worker: It’s a disgusting habit, it just goes willy-nilly. Even today I’ve smoked twice as much as I should. The cigarette just goes into your mouth. It’s like a dummy for a baby I think. (R53: 56-year-old male, construction worker) Many of the blue-collar workers, like Eeva, a 27-year-old construction worker, compared smoking to alcoholism: It was one summer when I made a bet with a carpenter. Then he changed sites [went away] and… I had one, and then I had another and the bet expired. And so it went on again… I shouldn’t have taken the first one… and when you’ve given in you realise what it’s like for alcoholics, for example. Maybe only then I realised how quitting smoking and 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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alcoholism… Like it’s always in your head, all the time you have to think that you just can’t have another. (R54: 27-year-old female, construction worker) A passive orientation towards smoking was typical of the blue-collar interviewees: it was described as compulsive and rooted in daily routines. Smoking was something that just happened for no special reason: Int: You said your husband smokes as well? R55: Yeah. Int: Do you smoke together? R55: Yeah. Int: Have you noticed that you smoke more if you’re with someone who smokes? R55: Yeah, maybe. Int: What do you think, why are you smoking more? R55: I don’t know… if it’s just the blood that demands more nicotine. Int: Does it actually feel like that? That’s the reason why? R55: I don’t know. I don’t know what to say about it. Int: What about changing your job? Would that have any effect? R55: No. (50-year-old female, construction worker) Here, the explanation given for the increase in the number of cigarettes smoked was neither in the respondent’s choice to smoke more, nor in some external factors that facilitated heavy smoking: it was attributable to the addictive power of nicotine. The focal difference between the manual and non-manual workers was thus in the ways of accounting for their smoking. Among the former, smoking was justified with several arguments; it was highly contemplated and the negative and positive aspects were deliberated upon. The relationship with smoking was active, and it was considered to a great extent to be a matter of choice. What was typical of the manual workers was the absence of expressions of will in their accounts, implying the greater importance of excuses for smoking. It seemed to be a self-evident part of their everyday lives, especially at the workplace. Differing smoking environments or differing habituses? There are several possible ways of explaining the differing account strategies between the manual and non-manual workers. First of all, differing work environments in which smoking took place must be taken into account. The biggest difference between non-manual and manual work environments was that smoking was simply very common in the latter. A social environment in which smoking is very common and, in a sense, self-evident, may easily facilitate its continuance without disruption, and consequently does not create the need to justify the habit. As long as the majority of employees smoke, it is likely to be deeply embedded in their work routines and smokers are therefore not compelled to reflect on their smoking. Secondly, the two groups also differed in how much they smoked daily. For example, the white-collar male respondents smoked an average of 13 cigarettes a day, whereas the bluecollar men had an average of 23. There were no substantial differences among the women, however. For the manual workers, who smoked more and were continuously surrounded by other smokers, the experience of addiction is likely to be more intense. The use of the passive mode in describing one’s smoking and the lack of justification may be directly connected to the experience of a severe dependency. 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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Thirdly, it is likely that the lack of justifications among manual workers is partly attributable to factors related to the interview situation. It is evident that the situation influences the account strategies. The emphasis of negative aspects and the more frequent use of excuses, especially among male manual workers, can relate to the fact that the interviewers were young females to whom the male respondents wanted give a good impression by showing that they did care about their health despite smoking. It is also possible that short, non-complicated responses may imply resistant attitudes towards the interviewers and the situation itself. This, however, was not evident with all manual workers. Atmosphere, especially at the construction sites, was welcoming and the construction men seemed rather flattered about the attention from young-looking females. Lastly, it is possible that a passive view of one’s own behaviour among manual workers is a more typical way of experiencing and expressing things among the working class. Previous studies have suggested that a lower class position is related to a reduced sense of personal agency and control over life (Lachman and Weaver 1998, Bosma et al. 1999), whereas people from higher socioeconomic groups are more likely to express a greater sense of control (Calnan 1987, Chamberlain and O’Neill 1998). These kinds of findings suggest that people in lower socioeconomic groups are more likely to view their own actions as less important with regard to their health status, and in the accounts of smoking this seemed to manifest itself in the use of the passive mode and a lower inclination to get rid of the habit. Consequently, the active and the passive accounts of the non-manual and manual workers respectively may reflect one of the basic indicators of social class, namely how much control an individual actually has over his ⁄ her work. Hence, the interview responses are not merely accounts of a personal habit, but they also articulate the individual’s position in the social hierarchy, namely his ⁄ her habitus.
Conclusions It seems contradictory that the non-manual workers, who according to surveys are less attached to smoking, were more positive about the habit. Interestingly, similar results have been reported by Chamberlain et al. (1998) in New Zealand. However, positivity about smoking as such is not likely to be relevant in explaining smoking behaviour and class differences. It is rather the way of reflecting the behaviour, most importantly the readiness to justify it, which is the key to understanding these differences. The non-manual workers reflected on their smoking from a number of perspectives and saw their smoking as governed by many rules. Through these rules smoking was presented as being under control and thus justified. What characterised the accounts of the manual workers was the self-evident way in which the smoking habit was presented and the more frequent utilisation of excuses. However, more research is needed to see if there are class-related tendencies to prefer excuses over justifications. Previous qualitative research on health-related accounts has highlighted people’s willingness to emphasise their good intentions regarding health, and to hide the pleasurable and irrational aspects of daily choices. This is an apparent problem in qualitative studies on health behaviour, and derives from the normative aspects of health discourse. ‘Healthy’ also defines what is considered to be normal and good, and accordingly, health-related talk is deeply, morally charged (e.g. Bolam et al. 2003). Therefore, accounts of health indicate not only what people think, but also how they feel they ought to think (Radley and Billig 1996). This tendency to prefer ‘public accounts’ over more private ones is well reported in previous studies on lay 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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health beliefs (Cornwell 1984), and the face-to-face interview situation may even reinforce it, especially when there is social distance between the respondent and the interviewer. At the same time, as many critics have noted, it may be difficult to separate public accounts from private ones. Alan Radley and Michael Billig (1996) argue that interview accounts are always produced in a certain situation, and therefore in studying them it is a question of examining people’s expressions of justification and what they are actually doing when they bring out their accounts in particular situations. This means that the analysis of accounts is not about analysing some stable attitudes, but rather the activity of accounting is always involved. Why do interviewees express a certain views in a particular situation? In this sense, the question of positive non-manual workers and negative manual workers needs to be put differently. Why were the accounts of the former group more positive about smoking? Why was it easier for them to bring out the ‘other side’ of smoking? Although it is easy to see smoking as a private addiction with no greater sociological significance, it nevertheless raises important questions about class and inequalities. This refers not only to inequalities in health, but also the extent to which it is possible for people from different social backgrounds to redefine and challenge the prevailing ideas of a good, ‘healthy’ life. Currently, members of the group that smoke the most – male manual workers – seem to be the least willing to defend themselves and to rationalise their behaviour, whereas the white-collar workers’ agenda could be interpreted as the reconciliation of a middle-class habitus with a risky habit. According to Bourdieu (1984), taste is always determined by those who have the symbolic power to legitimate their judgements and definitions, i.e. convert cultural into symbolic capital. Therefore, those who have access to symbolic power are able to take the properties and practices associated with the working class out of their context, re-code and re-signify them and utilise their exchange value (Skeggs 2004: 107). As Beverley Skeggs has noted (2004: 108), this can be seen as part of the wider process of self-resourcing among the middle classes. Although for a long-term, daily smoker smoking is not something that is adopted as a new, re-coded habit, it can be justified and signified as distinct from ‘other people’s’ smoking, thus becoming a resource in the field of class distinction. Accordingly, one’s own middle-class smoking is not associated with smoky, dependent (working-class) masses, but with a considerate and calculated, pleasurable way of life. Although medicalisation is the main factor affecting the current social status of smoking, it is an oversimplification to assume that it is purely a concern with health that makes it less appealing to the middle classes. What is relevant is not how significant or meaningful the smoker considers smoking to be, but the ability to see it from other perspectives and to recognise the social reactions related to it. The reflexive orientation and concerns about appearances related to different kinds of lifestyle choices generate habits that are under constant re-definition and re-adaptation. If the smoking habit is constantly under surveillance and reflection, bringing about change is also more likely. Address for correspondence: Anu Katainen, Department of Sociology, University of Helsinki, PO Box 18, Helsinki 00014, Finland e-mail: anu.h.katainen@helsinki.fi
Note 1 The interviews were done by the author and Hanne Heikkinen, National Public Health Institute, Finland. 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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References Archer, M. (2005) Making our Way through the World. Cambridge: Cambridge University Press. Bancroft, A., Wiltshire, S., Parry, O. and Amos, A. (2003) ‘It’s like an addiction first thing… afterwards it’s like a habit’: daily smoking behaviour among people living in areas of deprivation, Social Science and Medicine, 56, 6, 1261–67. Beck, U. (2000) Zombie categories,. In Rutherford, J. (ed.) The Art of Life: on Living, Love and Death. London: Lawrence and Wishart. Bolam, B., Hodgetts, D., Chamberlain, K., Murphy, S. and Gleeson, K. (2003) ‘Just do it’: an analysis of accounts of control over health amongst lower socioeconomic status groups, Critical Public Health, 13, 1, 15–31. Bosma, H., Schrijvers, C.T.M. and Mackenbach, J.P. (1999) Socioeconomic inequalities in mortality and the importance of perceived control: cohort study, British Medical Journal, 319, 1469–70. Bourdieu, P. (1977) Outline of a Theory of Practice. Cambridge: Cambridge University Press. Bourdieu, P. (1984) Distinction. A Social Critique of the Judgement of Taste. London: Routledge and Kegan Paul. Bourdieu, P. (1990) In Other Words: Essays Towards a Reflexive Sociology. Cambridge: Polity. Bourdieu, P. and Waquant, L. (1992) An Invitation to Reflexive Sociology. Cambridge: Polity. Calnan, M. (1987) Health and Illness. The Lay Perspective. London: Tavistock. Calnan, M. and Williams, S. (1991) Style of life and the salience of health: an exploratory study of health related practices in households from differing socio-economic circumstances, Sociology of Health and Illness, 13, 4, 506–29. Chamberlain, K. (1997) Socio-economic health differentials: from structure to experience, Journal of Health Psychology, 2, 3, 399–411. Chamberlain, K. and O’Neill, D. (1998) Understanding social class differences in health: a qualitative analysis of smokers’ health beliefs, Psychology and Health, 13, 6, 1105–19. Cornwell, J. (1984) Hard-earned Lives. Accounts of Health and Illness from East London. London: Tavistock. Coxhead, L. and Rhodes, T. (2006) Accounting for risk and responsibility associated with smoking among mothers of children with respiratory illness, Sociology of Health and Illness, 28, 1, 98– 121. Crossley, N. (2001) The phenomenological habitus and its construction, Theory and Society, 30, 1, 81–120. d’Houtaud, A. and Field, M.G. (1984) The image of health: variations in perception by social class in a French population, Sociology of Health and Illness, 6, 1, 30–60. Flint, A.J. and Novotny, T.E. (1997) Poverty status and cigarette smoking prevalence and cessation in the United States 1983-1993: the independent risk of being poor, Tobacco Control, 6, 1, 14–18. Gillies, V. and Willig, C. (1997) ‘You get nicotine and that in your blood’ – constructions of addiction and control in women’s accounts of cigarette smoking, Journal of Community and Applied Social Psychology, 7, 4, 285–301. Herzlich, C. (1973) Health and Illness: a Social Psychological Analysis. London: Academic Press. Hochschild, A. (1983) The Managed Heart. Commercialization of Human Feeling. Berkeley: University of California Press. Jarvis, M.J. and Wardle, J. (2006) Social patterning on individual health behaviours: the case of cigarette smoking. In Mamot, M. and Wilkinson, R.G. (eds) Social Determinants of Health. Oxford: Oxford University Press. Jefferis, B., Graham, H., Manor, O. and Power, C. (2004) Cigarette consumption and socioeconomic circumstances in adolescence as predictors of adult smoking, Addiction, 98, 2, 1765–72. Jenkins, R. (1992) Pierre Bourdieu. London: Routledge. Kilpinen, E. (2009) The habitual conception of action and social theory, Semiotica, 173, 1, 99–128. 2010 The Author Sociology of Health & Illness 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
Smoking and social class differences
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Lachman, M.E. and Weaver, S.L. (1998) The sense of control as a moderator of social class differences in health and well-being, Journal of Personality and Social Psychology, 74, 3, 763–73. Lamont, M. (1992) Money, Morals, and Manners: the Culture of the French and American UpperMiddle Class. Chicago: The University of Chigaco Press Laurier, E., McKie, L. and Goodwin, N. (2000) Daily and lifecourse contexts of smoking, Sociology of Health and Illness, 22, 3, 289–309. Lynch, J.W., Kaplan, G.A. and Salonen, J.T. (1997) Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse, Social Science and Medicine, 44, 6, 809–19. National Public Health Institute (2006) Good Research Practice in the National Public Health Institute. Helsinki: National Public Health Institute. Pakulski, J. and Waters, M. (1997) The Death of Class. London: Sage. Radley, A. and Billig, M. (1997) Accounts of health and illness: dilemmas and representations, Sociology of Health and Illness, 18, 2, 220–40. Scott, M.B. and Lyman, S.M. (1968) Accounts, American Sociological Review, 33, 1, 46–62. Skeggs, B. (2004) Class, Self, Culture. London: Routledge. Stead, M., MacAskill, S., MacKintosh, A., Reece, J. and Eadie, D. (2001). ‘It’s as if you’re locked in’: qualitative explanations for area effects on smoking in disadvantaged communities, Health and Place, 7, 4, 333–43. Sweetman, P. (2003) Twenty-first century dis-ease? Habitual reflexivity or the reflexive habitus, The Sociological Review, 51, 4, 528–49. Williams, S.J. (1995) Theorising class, health and lifestyles: can Bourdieu help us? Sociology of Health and Illness, 17, 5, 577–604.
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