Intended for healthcare professionals

Towards A Better World

Great expectorations! The decline of public spitting: lessons for passive smoking?

BMJ 1995; 311 doi: (Published 23 December 1995) Cite this as: BMJ 1995;311:1685
  1. Simon Chapman, associate professora
  1. aDepartment of Public Health and Community Medicine, University of Sydney, Sydney 2006, Australia

    As a boy growing up in a New South Wales country town in the 1950s, I well recall the official notice on the shop wall of Mr Bullock, our local butcher. “No spitting or smoking,” it warned. It is inconceivable, a mere 40 years later, that such a sign would mention spitting. Any butcher affronting his customers with the presumption that they were public spitters would risk getting the chop. Yet “no smoking” signs abound today, amid an often acrimonious 20 year long stoush between those who believe in smokers' “rights” and those bearing epidemiologically fuelled Millean precepts who believe the right to smoke ends where others' noses begin.

    There are two interesting parallels between public spitting and smoking. Both are “small behaviours” that have had their benign status as harmless pleasures eroded by, respectively, hygienists and their modern counterparts, the epidemiologists. The sentences passed on spitting and passive smoking by public health were both pronounced well after the two habits had been buffeted about by arbiters of etiquette as part of what the historical sociologist Norbert Elias has termed the “civilising process.”

    The demise of public spitting in most Western communities occurred well before what seem to be the first state sanctioned moves against it late last century. Elias in The History of Manners records 12 examples of proscriptions against spitting dating from the middle ages to 1910.1 In the middle ages, spitting at meals was permitted, provided it was under the table and not on or across it—a habit apparently common among boorish hunters. In 1530 …

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