Medicalization and representations of smoking in public discourse and images
An approach to smoking through an analysis of its representations, grounded in the medicalization literature, highlights the inadequacies of a narrow medical perspective and some of its negative implications. This does not require that we abandon the medical discourse, but stresses the importance of setting it in a wider representational context. Drawing on the work of Saussure, Barthes, Eco and Foucault, the author constructs a theory of interaction amongst representations suited to both discourse and images. To investigate the medicalization of smoking, four empirical studies are reported which include quantitative and qualitative approaches to press reporting at both macro-and micro-levels, cigarette advertising and packaging. There have been medical representations of smoking since the introduction of tobacco into Britain. However, a thematic analysis of tobacco-related reporting in the Times newspaper (1946-1995) found that these representations have expanded and diversified, becoming increasingly linked to other representations (e.g. financial) and generating new themes (e.g. discrimination, litigation). Medical representations, however, are contested and subject to subversion by alternative representations, including libertarian and alternative medical constructions of smoking. These processes are investigated in a detailed structural and rhetorical analysis of a contemporary newspaper article, together with related correspondence and cartoons. Quantitative and qualitative analyses of 754 UK cigarette advertisements from four national newspapers (1946-1995) identified an increase in medical and packaging-related representations of smoking and a decrease in financial representations, representations of the act of smoking and of cigarettes as social currency. The final, questionnaire, study (with 60 participants) found, among other things, a clear and consensually-held system of health-related signification in contemporary UK cigarette packaging in ratings of packets. The thesis concludes with a discussion of the implications of medicalization for smoking-related policy and for the smoker, and of smoking for the medicalization literature.