In May 2012 Michael Bloomberg, the mayor of New York City, proposed a ban on the sale in public places of large-sized containers (over 16 fluid ounces) of sugar-sweetened drinks. Most soda beverages will be affected. The ban will have to be promulgated by the city’s public health agency, which is controlled by the mayor—so it may be assumed that the ban will become law. It is to be introduced gradually, not to go into full effect until March 2013. In an address announcing this initiative, Bloomberg described it as the city’s response to obesity, described as one of the major health issues facing the nation. He referred to Michelle Obama’s anti-obesity campaign as a worthy antecedent (though, as far as I know, she has not advocated legal prohibitions). There have been some protests against this latest action of what some critics have called “Nanny Bloomberg”, by the beverage industry and some irate libertarians. This rather muted protest is not surprising since the actual impact of the ban will not be felt for some time.
Bloomberg (now aged 70) has been mayor of New York City since 2002, and is currently on his third term (he succeeded in overturning a term-limit law). He has switched party affiliation several times. Apparently he has been successful in improving the financial situation of the city. Before entering politics he had a brilliant career as a financier. In 2012 Forbes magazine estimated his personal wealth at 22 billion dollars, making him one of the richest individuals in the country. Whatever his motives in becoming a politician, greed clearly is not one of them. He refused the mayor’s salary, instead is paid the symbolic fee of one dollar per-annum. He also does not occupy the official residence of Gracie Mansion, and instead resides in his private apartment on the Upper East Side. His co-resident is a woman to whom he is not married—something that he would probably not get away with as mayor in many other American cities. In an international perspective, however, he is in good company—both the current presidents of France and Germany live with similarly non-matrimonial partners. I cannot say whether Bloomberg’s quasi-European lifestyle has anything to do with his idea of New York City as a quasi-European welfare state. He certainly has a very broad notion of the mayor’s responsibility for the wellbeing of citizens in many aspects of their lives—not just as a nanny, but as a fatherly Tsar of All the Boroughs watching over citizens who don’t know what is good for them. I have never met Bloomberg, but it is my impression that excessive modesty is not one of his problems.
A municipal ordinance to enforce a healthy diet obviously raises issues of individual liberty, especially since Bloomberg’s prohibition is likely to be a first step down a very slippery slope. What interests me here is an earlier action by Bloomberg which suggests an enduring pattern: Early in his career as mayor, he instituted a city law banning smoking in all public places, including restaurants and bars. Here too health was given as the reason—not the smokers’ health, but the health of non-smokers, especially employees, supposedly endangered by environmental tobacco smoke. (The smokers, officially designated sinners, presumably deserve any future illness caused by their filthy habit—and in any case they are already being punished here and now by having to smoke out on the street, preferably in freezing weather.) Let me suggest that the by-now victorious war against tobacco has useful lessons about the unfolding war against obesity.
In 1977 I published a short article in Worldview, a long defunct periodical with which I was then associated. The anti-smoking campaign was at a very early stage; I suggested that it was in an age-old tradition of the quest of immortality, first described in the ancient Mesopotamian Gilgamesh Epic. (Gilgamesh, plunged into grief by the death of a friend, sets out on an arduous journey to discover a plant that can bestow immortality. When he finally finds it, a snake comes and eats it. Gilgamesh sits down and weeps. But that is another story.) The new replication of this ancient fable contains an implicit promise: Refrain from smoking, and you will live forever. It follows, of course, that those who sell tobacco products are killers , which, I further suggested, explained the vehement passion of the anti-smoking activists. An unintended consequence of this article was that I was asked to advise a consortium of tobacco companies on a study of the anti-smoking movement. I did this for about three years, during which time I learned a lot about the politics and social psychology of morally inspired movements. Also, it so happened that I was able to observe from its beginnings an incredibly successful movement. Early on I attended a conference during which an activist uttered a sentence which then sounded quite mad: “The aim of the movement is to make smoking an activity undertaken in private by consenting adults.” This today describes the reality in most developed societies (and an increasing number of developing ones). This raises a very interesting question: How was this success achieved ? Please do not say that the movement had a message that was based on scientifically supported truth. The assertion that smoking is bad for the smoker’s health has indeed been scientifically supported; the assertion that tobacco smoke is bad for non-smoking bystanders is shakier. But I don’t think that this explains much. Most people are not equipped to assess the often complicated and sometimes contested scientific evidence. Even if they defer to alleged experts, the threatened dangers seem remote, and there are other more proximate dangers that one risks by this or that behavior. Let me answer the question of why the anti-smoking movement has been so successful:
The movement was concerned with something that everyone is afraid of—serious illness and early death. Fear is a powerful motivator. Of course I exaggerated a bit with the Gilgamesh metaphor—the movement did not offer immortality. But, in the words of a statement by the World Health Organization: The purpose of the WHO is that people should die young—as late as possible. Not a bad purpose in and of itself. Furthermore, lung cancer was the main disease attributed to smoking—and, until the advent of AIDS, cancer was the most feared disease. The movement could then use science to identify smoking as a major cause of the disease—very plausibly for smokers, less so for non-smokers—but data concerning the latter could be (let us say) creatively interpreted. To mobilize fearful people, it is very helpful to have an enemy at hand. An enemy was easily identified here—the industry with obvious tobacco interests (also known as “the merchants of death”). It helped the movement that tobacco companies initially denied any smoking risks and subsidized research that seemed to support the denial. The movement, in addition to its moral high ground (who could be for lung cancer?), also contained activists with career interests—as public attention veers away from one cause, activists must turn to another cause. But that is not enough. Successful morally inspired movements typically ally themselves with powerful groups motivated by very hard material interests. This has been true throughout history, from the Crusades (poor knights wanted to acquire real estate in the Holy Land), to the Protestant Reformation (German princes were eager to confiscate monastic properties), to the anti-apartheid movement (South African businessmen saw apartheid wrecking the economy). In this instance, the anti-smoking interests included the medical establishment (ever eager to prevent diseases that often cannot be cured, and also eager for new research funds), important branches of government bureaucracy (with an interest in new candidates for regulation), and, last not least, the legal profession. American tort law, coupled with the high costs of litigation, is an open invitation to extortion. I think the case can be made that lawsuits and the threat of lawsuits tipped the anti-smoking movements to its conclusive victory in the United States. The major tobacco companies calculated that even huge settlements were less expensive than endless litigation. They gave up the fight, even contributed to campaigns to curb teenage smoking. Some real or invented victims of smoking (among them states getting compensation for losses they supposedly incurred from the medical care of individual victims) were beneficiaries of these enormous settlements, but the major beneficiaries were tort lawyers.
I would not be misunderstood here: I am not proposing that all moral appeals are cynical strategies of material self-interest. Thus Luther was genuinely concerned with his question of “how to find a gracious God”, but many of the German princes who rallied to his cause had much less theological interests. Thus Harry Oppenheimer, the mining tycoon who was also a committed Christian, opposed apartheid on moral grounds, but it helped a lot when even Afrikaans businessmen concluded that their economic future demanded a radical change of racial policy. No doubt many if not most anti-smoking activists believed from the beginning that their cause saves lives, but it helped greatly when people and institutions with more selfish interests came aboard. There was an additional problem: At least in democratic countries, the anti-smoking movement had to contend with the argument that, if an individual wants to kill himself, that is his own business. Two counter-arguments emerged: The argument from social costs—I kill myself by smoking, but society has to pay for my medical expenses, the care of my surviving dependents, and the loss of my productive contribution. This argument validated the huge sums paid to state governments, despite its rather wobbly logic (it could be argued that my dying early actually saves society from the costs I would incur if I tottered on into senility). Then there was what I would call the argument from innocent bystanders—I may have the right to kill myself, but I don’t have the right to kill those who helplessly inhale my toxic smoker’s breath. It is this argument which was most successful in justifying the tsunami of anti-smoking laws that swept across the world in recent decades. Not surprisingly, children featured prominently in the list of innocent victims. Children have always been the sacred icon of innocence. One additional sociological point may be made here: there is the factor of class. At least in America, the college-educated upper middle class has been most susceptible to the anti-smoking message. Working class people are much more resistant. Thus the smoking issue has become yet another marker of the increasing polarization in the class system that has been noted by many observers of American society: The knowledge elite (aka the “new class”) does not smoke, eats organically grown food, and works out with compulsive regularity, and regards all of this as proof of virtue. The working class continues to puff away, as it gorges itself on hamburgers and slouches on sofas watching lowbrow soap operas. Smokers thus not only defy the health establishment, but the elite whose virtues it reinforces. In an increasingly polarized society, the smoking issue allows the winners and the losers of the class system to despise each other, and to be proud of their respective lifestyles. (In my neck of the wood one could engage in ethnographic field work by having alternate meals in the Harvard Faculty Club and an Irish bar in South Boston.) As usual, the winners have the upper hand in shaping the culture.
Back to the new war against obesity: It is not difficult to predict the trajectory which this project will follow. Very probably it will replicate, step by step, the war against tobacco. Once again, the basic rationale is the prevention of illness. Heart disease is the illness most closely associated with obesity—not as scary as lung cancer, but scary enough. The scientific validation of the project is clear—obesity is unhealthy. The same interests that supported the anti-smoking crusaders can be mobilized once again—doctors who jump on the prevention bandwagon when their ability to cure is often limited, researchers in need of funding, bureaucrats looking for new behaviors to regulate, activists in search of employment opportunities, and of course, legions of tort lawyers, salivating at the prospect of gargantuan settlements from the food and drinks industry. Pizza Hut and Pepsi Cola may take the place of Philip Morris as public enemies (and defendants in class-action lawsuits). The same arguments will serve to counter libertarian scruples—social costs and innocent bystanders. Children will again be featured in the litany of victims. (Michelle Obama understandably likes to preach in kindergartens and elementary schools.) Finally, class is again involved here: Upper income and higher education is associated with virtuous slimness, while all these fat working-class types waddle from Burger King to the unemployment lines. Just as the Victorian bourgeoisie tried to convert the poor slobs to its table of virtues (alcohol of course was then the most targeted vice), so the new bourgeoisie bombards the lower classes with its temperance crusade. (One might speak of the eternal return of the Salvation Army—George Bernard Shaw’s Major Barbara would today be reincarnated as a coach with Weight Watchers). It remains to be seen how far this will go before the Great Unwashed remember that, after all, they are (still) allowed to vote.
[Personal disclosure: I gave up smoking years ago. I have never liked the beverages targeted by Mayor Bloomberg. So, as they say in Texas, I have no dog in this fight. However, I have a fierce commitment to individual freedom, and a keen sense of the slippery slope which opens up when even a seemingly modest exercise of this freedom is arbitrarily taken away by government actions.]
Does this have anything to do with religion? I think it does. The quest of immortality is one of the most ancient religious themes. The health cult, with its mirage of endless youth if not immortality, is a quasi-religion. Its dogma is the obligation to live healthily. Like all religions, the health cult has a catalogue of virtues and a catalogue of vices, with rituals to affirm the former and ostracize the latter. There is also an equivalent of the Saudi Arabian police force dedicated to “the promotion of virtue and the suppression of vice”—an army of therapists, coaches, educators, advice columnists, dieticians, and other moral entrepreneurs. To date (still) they mainly rely on persuasion rather than coercion. Wait a little.