PASSIVE SMOKING AND ILL-HEALTH - PRACTICE AND PROCESS IN THE PRODUCTION OF MEDICAL KNOWLEDGE

This paper examines the development of medical knowledge about passive smoking from a constructionist perspective. It draws upon the work of Ludwik Fleck, particularly his central idea that facts are produced in relation to the possibilities of stylised thought. Early epidemiological insights into changing disease patterns, with regard to active smoking, are initially discussed and shown to be related to a style of thought which encourages the production of a world of disconnected bodies. The paper then explores how connections between those bodies were constructed, and the medicalisation of passive smoking advanced, by a stylised perception of tobacco smoke. Problems of 'subject' visibility, however, remained; problems overcome by the production rather than the revelation of facts, notably the distinction between mainstream and sidestream smoke. This development opened up the space for the emergence of the previously invisible passive smoker. This processual reordering of reality is then mapped onto other processual patterns and the stylisation of social relationships, particularly apparent in the later 'spouse as index' studies, is discussed. The point is further explored in an analysis of the ideas associated with biochemical markers, particularly the notion that once invisible social connections can now be rendered visible through a reading of these markers in the body.