© 2004 by Society for the Social History of Medicine
Smoking in Northern Ireland: A Case Study in Local Health Education, 1950–1973
1 Pro-Vice Chancellor and Professor of Economic and Social History, Queen’s University Belfast, Belfast BT7 1NN, UKE-mail: kd.brown{at}queens-belfast.ac.uk
Although tobacco smoking and its medical effects have both been widely studied, there have been few historical studies of how the evidence of a link between cigarettes and cancer, which began to impinge on the public consciousness from the 1950s, was translated into action at the local level in the United Kingdom. There is strong circumstantial evidence to show that, as elsewhere, the reluctance of Northern Ireland’s central government to respond positively to the growing medical evidence was driven by economic motives, although the key consideration was employment rather than revenue. At municipal level, the effectiveness of health education was consistently undermined, not only, as in Britain, by ideological and medical conservatism, but also by a parsimony deriving from an outmoded rating system and a restricted local government franchise. Predictably, County Medical Officers of Health were generally gloomy about the likely benefits of health education campaigns based in the localities, and while the long-term persistence of smoking rates higher than the UK average may reflect a different class structure in the region, the study strongly suggests that without effective central backing, their pessimism was well-founded.
Keywords: smoking, tobacco, cancer, Northern Ireland, local health authorities, health education, Medical Officers of Health