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A doctor-ridden Godforsaken race

Mike Fitzpatrick
British Journal of General Practice 2005; 55 (511): 151.
Mike Fitzpatrick
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In the first chapter of James Joyce's loosely autobiographical novel The Portrait of the Artist as a Young Man, he famously describes a family Christmas dinner in Dublin in the early 1890s that was spoiled by a bitter row over what was known in Ireland as ‘the national question’. The story is told from the perspective of the young Stephen Dedalus, Joyce's alter ego. The argument rages over the recently-deceased nationalist leader Charles Stuart Parnell, whose career had ended in disgrace after a divorce scandal. ‘For pity's sake and for pity sake’, implores Stephen's mother, ‘let us have no political discussion on this day of all days’. But her pleas fall on deaf ears as his father denounces the Irish people, who generally supported the clerical condemnation of Parnell, as a ‘priest-ridden Godforsaken race’, to the outrage of Stephen's pious and respectable aunt.

This memorable scene came to mind recently when a friend returned from spending Christmas in the Republic of Ireland and recounted a series of family disputes — not about the national question, but, during the first Christmas season under the new ban on smoking in public places, about smoking in the home. Ever since the ban was introduced to international acclaim last March, the front line in the war against smoking has moved from pubs and restaurants into the kitchens and living rooms of the Irish people. The displacement of historic political controversies by petty domestic strife over individual lifestyles reflects wider processes of disengagement and the ascendancy of preoccupations about disease and death over concerns about the social and political order. In the new millennium, Ireland has assumed a leading role in the globalised regime of medical regulation of behaviour in the cause of increasing longevity.

In Ireland, it seems that the early effects of the smoking ban have seen a decline in attendance and sales of alcohol in pubs and an increase in off-license sales for consumption at home — where people can (so far) continue to smoke while they enjoy a drink.1 Campaigners have already drawn attention to the fact that this is likely to increase exposure to passive smoking among those considered to be most at risk — smokers' children and their non-smoking spouses. Emboldened by the success of their ban on public smoking, anti-smoking crusaders have taken up the campaign against smoking in the home with renewed vigour: hence the spate of Christmas rows over recalcitrant home smokers.

Discussion in Britain, following the announcement of plans to proceed with further curbs on smoking in the public health White Paper in November, has followed similar lines. Although opposition politicians have been quick to point out that public bans are likely to result in increased smoking in private, they hesitate to draw the logical conclusion and recommend that Tony Blair should send his health commissars into smokers' homes to ‘support’ them in making the healthy choice to quit smoking. Of course, such a recommendation would be highly congenial to the authoritarian instincts of New Labour.

Scarcely had the remains of Britain's Christmas turkeys been cleared away when, on 27 December, the government launched its latest anti-smoking advertising campaign, this time targeted at families. The government's contribution to the festive season was to announce that ‘up to 3000 people will have died of smoking-related illnesses such as cancer and heart disease between Christmas Eve and January 4’. The series of five television adverts, featuring various funeral scenes, and showing families struggling to come to terms with the consequences of smoking-related cancer, aim to provoke parental guilt. They also inevitably provoke children's anxiety and anger over their parents' smoking, no doubt spoiling many New Year celebrations around the country and causing continuing intergenerational conflict and family distress.

It is possible that the increasingly coercive campaign against tobacco will reduce smoking and save lives. It is also possible that it will have a negligible effect, or even that it will prove to be counterproductive. While some doctors may relish the wider authority over personal behaviour that health-related campaigns have allowed them — taken over from the priests — the recent collapse in the status of the Irish clergy might warn them against the dangers of overweening arrogance in the enforcement of virtuous living.

As the Dedalus family Christmas dinner acrimoniously concluded over 100 years ago, ‘Stephen, raising his terror-stricken face, saw that his father's eyes were full of tears’.

  • © British Journal of General Practice, 2005.

REFERENCE

  1. ↵
    1. Allwright S
    (2004) Republic of Ireland's indoor workplace smoking ban. Br J Gen Pract 54:811–812.
    OpenUrlPubMed
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British Journal of General Practice: 55 (511)
British Journal of General Practice
Vol. 55, Issue 511
February 2005
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A doctor-ridden Godforsaken race
Mike Fitzpatrick
British Journal of General Practice 2005; 55 (511): 151.

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Mike Fitzpatrick
British Journal of General Practice 2005; 55 (511): 151.
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Print ISSN: 0960-1643
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