Introduction and historical background -- Tobacco as a comestible -- Pipe dreams -- Tobacco in indigenous trade -- Tobacco as an object of exchange between islanders and foreigners -- From tobacco trade to tobacco production -- Death, taxes, and tobacco control -- Aotearoa: "land of the long white smoke cloud": Pacific smoke inhalation case study number 1 -- U.S. associated Micronesia: Pacific smoke inhalation case study number 2 -- Native Hawaiians: kānaka maoli: Pacific smoke inhalation case study number 3 -- Tobaccosis: the tobacco syndemic
Tobacco kills 5 million people every year - and that number is expected to double by the year 2020. Despite its enormous toll on human health, tobacco has been largely neglected by anthropologists. This book combines an exhaustive search of historical materials on the introduction and spread of tobacco in the Pacific with extensive anthropological accounts of the ways Islanders have incorporated this substance into their lives. The author uses a relatively new concept called a syndemic - the synergistic interaction of two or more afflictions contributing to a greater burden of disease in a population - to focus at once on the health of a community, political and economic structures, and the wider physical and social environment to ultimately provide an in-depth analysis of smoking's negative health impact in Oceania. In this book, the idea of a syndemic is applied to the current health crisis in the Pacific, where the number of deaths from coronary heart disease, cancer, diabetes, and chronic obstructive pulmonary disease (COPD) continues to rise. The case is made that smoking tobacco in the form of industrially manufactured cigarettes is the keystone of the contemporary syndemic in Oceania. The author shows how tobacco consumption (particularly cigarette smoking after World War II) has become the central interstitial element of a syndemic that produces most of the morbidity and mortality Pacific Islanders suffer. This syndemic is made up of a bundle of diseases and conditions, a set of historical circumstances and events, and social and health inequities most easily summed up as "poverty." He calls this the tobacco syndemic and argues that smoking is the crucial behavior - the "glue"--Holding all of these diseases and conditions together. This book offers an examination of the damaging tobacco syndemic in a specific world region, and will be of interest to scholars and students of anthropology, Pacific studies, history, and economic globalization, as well as for public health practitioners and those working in allied health fields. More broadly, the book will appeal to anyone concerned with disease interaction, the social context of disease production, and the full health consequences of the global promotional efforts of Big Tobacco
Book reviewed in this article:The Ngatik Massacre: History and Identity on a Micronesian Atoll. Lin Poyer. Washington, DC: Smithsonian Institution Press, 1994. 298 pp. Early Observations of Marquesan Culture, 1595–1813. Edwin N. Ferdon. Tucson: University of Arizona Press, 1993. 184 pp.
