Vienna is a pretty good place to be in late November/early December with the advent markets getting going and the city decked out for Christmas. With that in mind, Andrew Russell (CMH Affiliate and Co-Chair of the Smoking Interest Group) and I decided to submit an abstract for the 15th Anniversary Conference of the Work Group in Medical Anthropology of the German Anthropological Association. The intriguing title of the conference, held at the University of Vienna from 29th November to 1st December, was Beyond Boundaries: Interstices in Medical Anthropology, and this allowed us to take an interdisciplinary approach in our paper based on our joint work on smoking: ‘The mindful smoker – a prolegomenon for future work in tobacco control’. It thus derives very strongly from a seminal paper in Medical Anthropology, Nancy Scheper-Hughes and Margaret Lock (1987)’s ‘The mindful body – a prolegomenon for future work in medical anthropology’. In applying the insights from this article to ideas about ‘the smoker’ in contemporary public health, we drew upon work in our paper (co-authored with Susana Carro-Ripalda), ‘Risking enchantment’: how are we to view the smoking person and Andrew’s ongoing work on the role of tobacco companies in sustaining and extending smoking.
We were part of a panel whose focus was ‘the interstitial body’ and it was extraordinary how similar were some of the insights from a paper by Karin Eli (University of Oxford) on ‘Liminal Living: eating disorders and the interstices of being and coping’. In her paper, Karen describes a ‘relationship’ between the person and their eating disorder which seemed very similar to that between the smoking person and their cigarettes which we described in our paper. One interviewee comments: ‘You are having a relationship with the eating disorder, you are not having a relationship with the world, and you don’t care about the world’. That relationship is something of one’s own that carves out space within a difficult world, ‘something no-one will touch’ which transforms a space into one’s own world. Those experiencing eating disorders are aware of how dangerous they are but are so conscious of the benefits they experience, that they are prepared to take the risk: ‘on the one hand, it’s what’s killing you, but on the other hand it’s your medication.’ This quote is particularly close to one we quoted by a smoker in a paper from South America: smoking is ‘the best and worst friend you can have….it is worse because it kills you, but it causes great pleasure’.
Discussions following both papers enabled us to bring out more of the ambivalence people feel in their experience of both eating disorders and smoking, not just conceptualising them bluntly as ‘coping’ mechanisms, but as ways people find to enhance their lives. This is a problematic approach within a biomedical world view, where it feels uncomfortable to acknowledge that disorders or habits that have adverse effects on health can also have positive elements, but we all agreed it was important to examine these experiences in order to have a more comprehensive understanding and, perhaps, strengthen the means at people’s disposal to recover from or give up their habit.