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An anti-smoking ad from 1985 and a photo of a mask protester from 2020.

The Air We Breathe:” Dr. Martha N. Gardner Compares Initial Public Smoking Restrictions to Current Mask Guidelines

  • Dr. Martha N. Gardner, PhD, a historian and Associate Professor of History and Social Sciences at MCPHS, recently delivered the latest installment of the University’s COVID-19 webinar series, Revisioning the New Normal. Her talk was entitled, “The Air We Breathe: Exploring Why Initial Restrictions on Smoking in Public Were More Socially Acceptable Than COVID-19 Mask Laws Are Now.”

    One of the classes Dr. Gardner teaches is “Cigarettes in American Culture.” As an expert on the subject, she is more aware than most that, for a huge portion of the 20th century, cigarettes were everywhere in America. Indoors. Outdoors. At the workplace. In the home. In doctors’ offices and on airplanes. They were even touted as helpful for digestion. Everybody was smoking. Fast forward to today: smoking is frowned upon in many ways. To be clear, Dr. Gardner doesn’t like the idea of vilifying or shaming anyone for smoking, but it shows just how vast the cultural shift toward smoking has been—it’s often hailed as one of the greatest public health achievements in American history. In 1964, a landmark Surgeon General’s report was published that clearly and definitively linked smoking to cancer and other health problems. During the 60s, 70s, and 80s, more and more restrictions on smoking in public were introduced. There were some discussions of smokers’ rights, but they were not very widespread, and they were often promoted by the tobacco industry. People tended to agree that people had a right to clean air in public.

    So how is it that the government was able to severely restrict a widespread American pleasure with little resistance, when today a simple mask to help protect our health is seen by many as “the new symbol of tyranny?”

    The first, and perhaps most vital, issue Gardner sees is an erosion in trust of government and science. The public health report that came out in 1964 was the work of a bipartisan committee approved by both federal agencies and the tobacco industry itself. It was a huge and well-rounded effort showing that smoking caused cancer. The science led to consensus and unanimous conclusions, and the report’s language was clear and blunt. The message from the top levels of government was unmistakable: smoking causes cancer.

    Messaging from the top levels of our current government have been far less clear around masks. “The messages from the American government have been somewhat inconsistent,” Gardner says. Not only have mask recommendations flip-flopped, but even the latest messaging from the CDC is full of vague language like “masks may help prevent” and “masks are most likely to....” To be fair, of course, this is a new virus, whereas the study of smoking’s effects was conducted over many years. But we know that masks help stop the spread of the coronavirus, and Dr. Gardner does not believe the CDC and other government leadership are providing clear enough messaging for Americans with “may” and “most likely.” “These are not strong messages,” she says, and government guidance “doesn’t give you a sense of where the evidence is coming from.” She points out that this downplaying of the evidence might be political: “We have the CDC’s former leaders saying that science has never been politicized like it is now.”

    The politics of mask-wearing don’t end with a government trying to downplay the virus’ threat. Because of the unclear government messaging and a failure to lead by example, many people find being told to wear a mask a threat to their freedom. And “to an extent,” Dr. Gardner says, “it is. When you think about a lot of public health messages, sometimes they do restrict what you can and can’t do. But the question is the reason for that, and who else’s rights you might be trampling on” by not following the health messages. When the movement to restrict public smoking began, great efforts were made to show that second-hand smoke harmed innocent nonsmokers. Messaging with a similar theme, about masks keeping other people safe, could be effective. But blowing proven-harmful smoke onto bystanders is an easier problem to understand than possibly infecting someone else with coronavirus, Gardner says, so people have a harder time making the connection that wearing masks is a way to prevent harm. She adds that, “Not everyone was a smoker, so when we were talking about limiting smoking, we were talking about limiting some people’s behavior. In this case, we’re thinking about limiting everyone’s behavior.”

    Dr. Gardner points out that smoking restrictions weren’t immediately passed in full measure. Things got watered down in Congress. “We needed the grassroots public smoking message or else we would have had a hard time changing our cultural perspective of smoking,” she says. She doesn’t know the exact answers for how to make mask-wearing the norm as we fight this coronavirus pandemic. But she believes it begins with clear science and a public that trusts the evidence instead of politicizing it.

    Watch Dr. Gardner’s full webinar, with comments and questions from the audience.

    Caption: An anti-smoking ad from 1985 and an anti-mask sign at a Tulsa, Oklahoma reparations rally in July 2020.