Book Review: Laura D Hirshbein, Smoking Privileges: Psychiatry, the Mentally Ill, and the Tobacco Industry in America

Abstract

In the USA, cigarettes have provoked numerous questions about scientific authority, public health, corporate malfeasance, and the construction of medical knowledge. In Laura D. Hirshbein’s significant new monograph, Smoking Privileges, readers are exposed to the intriguingly hazy history of tobacco use in mental health. The ‘relationships between tobacco-related disorders and serious mental illness’, she argues, ‘need to be worked out in the big picture of mental health policy’ (p. 144). This book is a substantial start. Hirshbein sets her book against the backdrop of post-war American psychiatry, a time when psychoanalysis was in a full-blown battle with the proponents of biological psychiatry, when social psychiatry was contested, when deinstitutionalization reconstituted traditional mental health services and when breakthroughs in psychopharmacological research reshaped treatments. Running parallel to these developments was the escalation of the tobacco-control movement in the 1960s.