The potential of a more playful public health: Examining a bar-based anti-tobacco intervention for young adults

Authors: Julia McQuoid*, University of California, San Francisco, Pamela Ling, University of California, San Francisco
Topics: Medical and Health Geography, Geography and Urban Health, Qualitative Research
Keywords: health geography, qualitative, health behavior, play, substance use
Session Type: Paper
Day: 4/5/2019
Start / End Time: 1:10 PM / 2:50 PM
Room: Council Room, Omni, West
Presentation File: No File Uploaded


Behavior denormalisation has been a core component of anti-tobacco public health campaigns in the United States and has likely contributed to reducing tobacco use at the population level. An obvious and unfortunate potential effect of denormalisation is that it can stigmatize those who engage in the denormalised behavior. This is especially problematic for tobacco use, given that it is increasingly concentrated within socially marginalized groups (e.g., racial/ethnic/sexual/gender minorities, individuals with mental and/or substance use disorders, or homelessness). Thus, tobacco denormalisation may compound experiences of stigma and further marginalize rather than improve the health and wellbeing of disadvantaged groups. Calls have been made for alternatives to denormalisation that address social and environmental determinants (e.g., concentration of tobacco retail in low-income neighborhoods), as well as innovations in non-stigmatizing approaches to discouraging tobacco use. This paper examines two anti-tobacco interventions, COMMUNE and HAVOC, which were designed to engage with high risk young adults and took place in bars in California, Oklahoma, and Minnesota. We draw from in-depth interviews with 27 young adults who were involved in the interventions (e.g., event organizers, ambassadors, musicians, artists, event attendees) and ethnographic observation of two intervention events. Participants emphasized the playful, immersive, and non-stigmatizing qualities of the event environments as enhancing receptivity to anti-tobacco messaging. We reflect on the properties of play and playful environments in relation to health behavior change, considering psychological theories of play (e.g., game theory), and social and cultural geographical work on therapeutic landscapes and transformative relationships between space, bodies, and ideas.

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