Binge drinking: an exploration of a confused concept.

Binge drinking is a matter of current social, media and political concern, and the focus of much policy activity in the UK. Binge drinking is associated with causing a wide range of harm to individuals (e.g. accidents), and the wider community (e.g. crime and disorder). Within the current discourse, binge drinking is seen primarily as a youth issue. Binge drinking is sometimes portrayed as a recent phenomenon, but we know from history that heavy drinking has been endemic in British society over many centuries. Using a contemporary history perspective, this paper explores the concept of binge drinking. It considers the definitions in use, recent shifts in meaning and also the way in which different definitions of binge drinking impact on perceptions of the extent and nature of binge drinking. The paper concludes with some thoughts and questions about the usefulness of the concept of binge drinking as it currently used, and areas for further research.

Multidisciplinary public health: what sort of victory?

Multidisciplinary public health (MDPH) has been a phenomenon in the UK of the 1990s and the early 21st century. Its achievement has been seen as a victory for non medical interests. While acknowledging this, the paper questions what sort of victory this represents. Public health in its sanitary phase in the mid-19th century was, after all, what passed for multidisciplinary with its mix of engineers, doctors and statisticians. Is the present simply a return to the sanitary phase? The paper argues that it is not, and that contemporary public health badly needs clearer definition. It identifies three dimensions of recent public health. Public health can be an occupation; a discourse or movement, and also an institutional location of which public health research is part. Looked at in this frame, public health has been multidisciplinary in the post war period. The development of public health research out of social medicine in the 1950s was multidisciplinary. Public health campaigning, separate from public health professionals, has also been multidisciplinary since the 1970s. Public health as an occupation has been preoccupied with its professional positioning. Will the wider multidisciplinary impetus of public health now be lost in a preoccupation with status?

Constructing women and smoking as a public health problem in Britain 1950-1990s.

Historical analysis of the topic of women and smoking has concentrated on the early part of the twentieth century and on the challenge which smoking by 'new women' or 'flappers' offered to dominant notions of womanly behaviour. This paper considers, rather, the dominant constructions of women and smoking in the UK offered through the prism of changing versions of public health in the last fifty years. The construction of women and smoking, it is argued, has been emblematic of those policy agendas within public health and has borne a reciprocal relationship to them. The traditional view of women as mothers has been renegotiated and redefined through the new scientific alliances of late twentieth-century public health. These constructions have helped to set the parameters of discussion within which policy has been made.

Opium in 20th-century Britain: pharmacists, regulation and the people.

AIMS: To indicate how the system of pharmaceutical regulation of the sale and use of opium in Great Britain continued throughout the first half of the 20th century. DESIGN: An oral history investigation of community pharmacy in Great Britain (n = 50), together with an analysis of standard pharmaceutical texts. SETTING: Community pharmacies in Great Britain during the 20th century. PARTICIPANTS: Retired community pharmacists with experience of the sale and use of opium during the period. MEASUREMENTS: Oral testimony of retired community pharmacists about the use and sale of opium, and quantitative analysis of numbers of official preparations of opium available during the period. FINDINGS: The popular use of opium continued well after the First World War, and its use as an ingredient of prescribed medicines continued well beyond the introduction of the National Health Service in 1948. CONCLUSIONS: Although the role of pharmacy in the regulation of opiates and other drugs was displaced by medicine following the passage of dangerous drugs legislation in the 1920s, pharmacists continued to play an important part in this regulation, exercising considerable discretion in the process.

Passive smoking and its pre-history in Britain: policy speaks to science?

This paper analyses the emergence of passive smoking as a 'scientific fact' and its relationship to policy objectives for smoking control in the UK in the 1980s and 1990s. It relates this 'discovery' to the emergence and changing objectives of the post-war public health coalition, founded on the concepts of epidemiology. It examines the reciprocal relationship between scientific facts and policy aims, arguing that passive smoking was a 'scientific fact waiting to emerge'. Its conceptual and policy implications embodied the environmental individualism of late twentieth century public health and the alliances with technology and biomedicine within it.

Histories of harm reduction: illicit drugs, tobacco, and nicotine.

This paper traces the different historical routes which the public health concept of "harm reduction" has taken for illicit drugs and for tobacco and nicotine. It locates these different recent histories, not just in degrees of dangerousness or risk, but rather in the ways in which those concepts have been mediated through intervening factors. It identifies institutional and cultural/conceptual planes for discussion. Key issues include different routes of medicalization; the role of differing policy communities; changing cultural and class positioning; and the shifting of boundaries between categories of "substance," "drug," and "medicine." [Translations are provided in the International Abstracts Section of this issue.]

Why have attitudes to industry funding of research changed?

This paper discusses the history of the changing relationship between research and industrial funding, using the tobacco industry as its example. It seeks to explain why funding which was once acceptable is now unacceptable. The hypotheses advanced include: the changing nature of the industry's interest in research and the role of marketing; the rise of the 'new public health' alliance focused on abstention rather than on harm minimization; the role of government funding and control of research; and the changing meaning of tobacco and especially nicotine.

'Special units for common problems': the birth of alcohol treatment units in England.

In 1962 the Ministry of Health issued a memorandum entitled The Hospital Treatment of Alcoholism. The memorandum was the first official statement specifically regarding the treatment of alcoholism within the National Health Service. It marked the end of an era characterized by Ministry of Health rejection of the need to review policies regarding alcohol consumption and alcoholism treatment and the entry of the Ministry into the emerging alcohol arena. This paper uses documentary sources and interview material to examine the events leading up to the memorandum and its recommendation to Regional Health Authorities to establish specialist alcoholism treatment units. The development of such units was not supported by everyone in the alcohol field at that time and the paper discusses the pressures on Department of Health officials which appear to have influenced policy choices. The fact that pressures come from different sources, some advocating different policy options, raises the question: did medical perspectives and evidence for the specialist treatment approach influence policy or did policy makers select the option best fitted to existing Departmental interests?