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 Erasmus counselled that it was “unmannerly to suck back saliva, as equally are those whom we see spitting at every third word not from necessity but from habit.” He advised that one should “turn away when spitting, lest your saliva fall on someone” and recommended the use of “a small cloth.”1

    Writing in 1558, the worldly Della Casa had “often heard that whole peoples have sometimes lived so moderately and conducted themselves so honourably that they found spitting quite unnecessary.”1 By the 15th century, Courtin observed that “formerly … it was permitted to spit on the ground before people of rank, and was sufficient to put one's foot on the sputum. Today that is an indecency.”1 An anonymous French writer on manners suggested, “Do not spit so far that you have to look for the saliva to put your foot on it.”1

    By the 18th century, writings indicate spitting remained commonplace (“You should not abstain from spitting, and it is very ill mannered to swallow what should be spat”) and that the etiquette of spitting, at least among the bourgeois who read such guides, was to be determined by the company one was in (no spitting “when you are with well-born people”) or the location (“not in all places with waxed or parquet floors” or not “in church, in the houses of the great, and in all places where cleanliness reigns”).1

    Spitting by the proletariat apparently showered down relentlessly. Smith reports that in Britain “spitting on the floor in factories—and in hospital waiting rooms—was apparently acceptable until at least 1914”2 and that domestic servants, charwomen, and shop assistants were instantly dismissed if they were caught spitting. In 1908 Linethal in Massachusetts reports a health inspector saying that spitting on the floor was common in every tailor's shop he visited, but the attitude of employers was that “of course they spit on the floor; where do you expect them to spit, in their pockets?”3

    Campaigns against public spitting and the disposal of sputum in households seem to have started in the 1880s, driven by concerns about tuberculosis. In 1886 the French Hygiene Council issued the first public orders against spitting,4 and New York City issued a strong ordinance against public expectoration in 1896.5 Exhibitions featuring charts and models explaining the dangers of spitting were held in New York state in the 1890s.5 By 1916, 195 of 213 American cities with populations over 25000 had rules in force against public spitting.6

    Teller comments that “these rules were usually classic examples of the ineffectiveness of legislation enforced by apathetic authorities on an indifferent public.”5 A study of 74 cities with spitting laws showed that only 36 had made any arrests and only 13 made more than 20 arrests. New York was apparently the mecca of antispitting zealotry and had made 2513 arrests—73% of the national total.7

    Sullivan, the American historian, wrote, “When it became apparent that American regard for the rights of the individual—and the ease of getting a political friend to speak a word to the magistrate—would often not countenance punishment for so slight an offence, policemen were reduced to handing printed warnings to offenders.”8 In bar rooms and other places of public congregation, signs appeared such as “Gentlemen will not, others must not spit on the floor,” the sarcastic “If you spit on the floor at home, you can do it here,”8 and “MY FRIEND. Let me remind you that spitting on the sidewalks, in the street cars, or in any public place is forbidden by law. It is unsanitary and a menace to the health of others. It spreads TUBERCULOSIS. Every gentleman will obey the law and respect the rights of others.”9 In Cincinnati, 700 Boy Scouts and members of the Anti-Tuberculosis League painted thousands of “Don't Spit” signs on the sidewalks in one night.10

    In Britain, however, spitting in public, at home, and in Welsh public houses11 was still prevalent in the mid-1930s. Unlike in the United States and several European countries, antituberculosis activists had failed to have it made a legal offence.12

    These brief historical fragments give some sense of the decline of public spitting through history and of how public authorities attempted to both dissuade and legislate against the practice. Histories of the antituberculosis movement fail to give much insight into the social reception afforded to efforts by health educators and other public health officials to change the practice. Nothing seems to have been documented, for example, that indicates any backlash from people arguing about any cherished freedom to spit, that a ban on spitting was the beginning of a slippery slope which would see calls for an end to public laughter or glass sharing, which are other ways of spreading saliva about. Were indignant letters written to the Times by exasperated expectorators who had been made to feel like moral lepers? Did spittoon manufacturers write impassioned letters about having to lay off apprentices thanks to the antics of the “spitting police”? Were there any celebrated cases of civil disobedience involving publicity stunts of defiant spitting at the feet of hygienists? With colleagues in the United States and Britain, I am currently investigating these fascinating possibilities.

    Today, the notion of “smokers' rights” has widespread, if besieged, currency in many industrialised nations. Yet the parallel notion of “spitters' rights” is instantly laughable, as indeed would be urinators' or farters' rights—two other small behaviours that provide relief and some pleasure to the perpetrator. The first mention of passive smoking appeared in 1974.13 A mere 21 years on, smoking is banned on most short haul and many longer airline flights, in all Californian and larger New York City restaurants, and in many workplaces. In Australia, well over 90% of large office buildings and companies ban smoking at work and one in six smokers report going outside to smoke, even when in their own homes.

    With such a pace of change, and in light of the centuries it took for spitting to be relegated to the bathroom and the sporting field, might the idea of “smokers' rights” sound equally as ludicrous to the next generation?