Post-war smoking policy in the UK and the redefinition of public health

Current analyses of UK smoking policy within two frameworks--the 'heroes and villains' view of journalist accounts and a political science emphasis on rival 'producer' and 'issue' networks in policy making. It is often assumed that the US experience provides a universal historical model. This paper sees smoking policy in the UK as a case study in the relationship between 'scientific fact creation' and policy, which has also been emblematic of wider changes in public health ideology. The issue of smoking and lung cancer symbolized the post-war shift from infectious to chronic disease and the rise of a new 'lifestyle'-oriented public health. In the 1980s passive smoking brought a revival of environmentalism; in the 1990s the rediscovered concept of addiction symbolized developments in public health in which curative and preventive initiatives were entwined. Despite the rise of a militant 'healthism' within both anti-smoking and public health since the 1970s, British policy retained a dual focus, an emphasis on risk reduction as well as risk elimination in which policy networks were entwined rather than distinct. Some public health scientists worked in policy milieux, notably the expert committee, which crossed this apparent divide and which linked with industry. Connections between government and industry changed as public health 'treatment' brought the pharmaceutical industry into the picture.