Category: Applied Anthropology

Tobacco Worse Than Cocaine?

Gas Deal
By Mariana Cuervo, Elizabeth Montana, Brian Smith, and Sadie Pitzenberger

Is your local gas station attendant a drug dealer? Most people would say no, yet he readily deals all day long with customers looking for their next nicotine fix. Nicotine, the addictive substance in tobacco, keeps its users hooked.

Even though most people do not consider tobacco to be a drug, this post will show that it is exactly that. Tobacco delivers similar neurobiological effects as illegal substances like cocaine, methamphetamine and marijuana, all more commonly associated with the word “drug.” With tobacco, however, advertising and the law contribute to the common perception that tobacco is not a drug.

Tobacco Products

Just like on the street corner, where you might be able to buy crack, marijuana or meth, a gas station offers different types of drugs. Tobacco itself comes in many forms: dip, snuff, cigars and, of course cigarettes.

Chewing tobacco or “dip” is a smokeless form of tobacco, which when packed into the lip allows nicotine to flow into the bloodstream via the gum line. Snuff, a finer form of tobacco, is snorted while cigarettes are smoked. Both provide an alternative way to get a nicotine high.

The ways in which these tobacco products are consumed mirror the techniques of cocaine consumption – coca leaves are chewed, cocaine is snorted, and crack is smoked. So how is tobacco different?
Cigarette Poisons
And just like marijuana tobacco is grown in the ground, picked and dried, and then rolled into cigars and cigarettes. Tobacco has nicotine while marijuana has tetrahydrocannabinol (THC). Both are responsible for getting the user high.

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Calories Not Diets

Have a favorite way to lose weight, one that has worked for you? As long as it involves cutting calories over the long term, then it will probably be effective. That’s the basic lesson from the latest research.
frank-sacks
Last week Frank Sacks, a Harvard professor of nutrition, and his colleagues published a major study in the New England Journal of Medicine, Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein and Carbohydrates (full text). A total of 811 participants from Boston and Baton Rouge were divvied up into four diets with different emphases on protein and fat. The participants were then followed over two years. The conclusions, as summarized by Journal Watch, were:

Changes in weight and waist circumference at 6, 12, 18, and 24 months were indistinguishable among groups: At 2 years, only about 15% of each group had lost at least 10% of body weight. Attendance at group counseling sessions strongly predicted successful weight loss.

So there’s the catch! The weight loss was modest. As the Journal Watch title puts it, “Four low-calorie diets yield the same mediocre results. Dieters ate different amounts of protein, fat, and carbohydrate — but, after 2 years, most were still obese.” Still, many people would accept an average loss of 9 pounds and 2 inches less of waistline.

The main implication of this study is that calories matter, not diets. As Frank Sacks emphasized in a great interview on Science Friday, most research on diets has focused on the short-term. But weight loss is a long-term problem – and there calorie restriction is what really adds up. How to achieve that is a major issue, which I considered at length in a previous post on successful weight loss.

In the Science Friday interview Sacks himself ends up advocating a “very common sense approach – to have portion control, to cut out the highest calorie stuff you are eating, and getting some exercise. It’s all an integrated whole.” To that end, Sacks says that individuals should experiment with different diets to see what works for him or her.

On the research side, Sacks bluntly states that “we should move on from trying to figure out which diet is best.” Rather, we should examine why individuals vary so much in their response to weight loss programs. “The difference in individual response just overwhelms any possible dietary difference.”

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Mark Nichter and Global Health

Mark Nichter is a prominent medical anthropologist who teaches at the University of Arizona. In this video Nichter speaks on medical anthropology and health policy. We also get more background on Nichter and his work from colleagues and students.

I am using Mark’s new textbook, Global Health: Why Cultural Perceptions, Social Representations, and Biopolitics Matter, in my Intro to Med Anth class this semester, and the students have responded quite positively. It’s a relatively short book, so I am able to use it in conjunction with other texts – not the mega intro to all things med anthro that seems to be the norm out there now. I also like the practical/applied focus that he provides throughout the book.

The last chapter, “Toward a Next Generation of Social Science Research,” is the real pay-off after previous sections on both popular health culture and international health policy. That’s where he discusses global health, syndemics, ecosocial epidemiology, local biology, the importance of studying up, biopolitics, and more. Yes, he packs a lot in – but that leaves room for me as the teacher to discuss more general issues and to provide background for the points he is making.

Mark has several recent articles which will likely interest readers:

Coming to Our Senses: Appreciating the Sensorial in Medical Anthropology (2008) in Transcultural Psychiatry

Reconsidering the Placebo Response from a Broad Anthropological Perspective (2009) in Culture, Medicine and Psychiatry with Jennifer Jo Thompson and Cheryl Ritenbaugh

Qualitative Research: Contributions to the Study of Drug Use, Drug Abuse, and Drug Use(r)-Related Interventions (2004) in Culture, Medicine and Psychiatry with Gilbert Quintero, Mimi Nichter, Jeremiah Mock and Sohaila Shakib

Forever at War: Veterans’ Everyday Battles with Post-traumatic Stress Disorder

ptsd-iwo-jima“To this day, every time I smell firecrackers or fire arms being shot, I feel like I am right back there. All I have to do is close my eyes and I see the whole scenario over and over again. I can’t erase it.”

Hundreds of thousands of US veterans are not able to leave the horrors of war on the battlefield. They bring the combat home and re-experience it in their minds each and every day, no matter how much time has passed.

“I don’t like people. I just live my life.”

Many PTSD veterans live a life riddled with divorce, unemployment, and loneliness because they are unable to form lasting social networks within civilian life. It is not uncommon for a war veteran plagued with PTSD to desire a solitary life in the mountains. One informant described Montana as the ideal locale – far away and quiet.

“I should have buried him.”

This veteran is still tormented by the fact he did not give an honorable burial to a fellow soldier. He knows he would have met a similar fate if he tried to leave his foxhole; yet his inability to act haunts his memory. He asks himself everyday why he didn’t even try to honor his fallen comrade. He also has never been able to justify why he wasn’t the soldier left unburied on that remote Pacific island.

“I didn’t even have the motivation to kill myself.”

Many of these men and women believe their situation will never improve. Some contemplate suicide as their only relief from the symptoms of PTSD. A number of the veterans we spoke with had thought about or even tried to end their own lives. They also participate in risky activities, threatening their life in a deliberate yet indirect way.

“I always feel like there is someone behind me – following me.”

Being on edge is the only way to survive in combat. Unfortunately, many PTSD veterans are unable to readjust within the civilian world. Everyday life becomes a battlefield.

Something as mundane as walking through a crowded grocery store aisle can be a source of intense anxiety for a veteran suffering from PTSD. Overwhelmed by a feeling that the shoppers behind them are enemies, PTSD veterans always feel as if they are under attack. A trigger as simple as the clashing of shopping carts can make them jump in fear of an imminent explosion. They are forever at war.

OUTREACH

Over the course of 4 months, South Bend veterans with Posttraumatic Stress Disorder (PTSD) have revealed their daily realities to us, five undergraduates at the University of Notre Dame. In conjunction with a course taught by Dr. Daniel Lende entitled Researching Disease: Methods in Medical Anthropology, we have engaged in community-based research with members and supporters of PTSD, Vets, Inc. Here, with the approval and encouragement of these vets, we seek to give their experiences a well-deserved voice.

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More Than A Waiting Room

main-waiting-room1By Jillian Brems, Erin Brennan, Katrina Epperson, Jordan Pearce & Anna Weber

“I just don’t want this to be the visit that changes my life,” said the middle-aged woman waiting for a mammogram at the Regional Breast Care Center. For an estimated 240,510 women diagnosed with breast cancer in 2007, their visit to the waiting room did change their lives. This is the concern that patients and their friends, families, and significant others face every time they visit the center.

This feeling of stress and anxiety isn’t just for first-time visitors either. Even women who have had many mammograms worry before a visit because, as one patient put it, “You just never know.” Women are forced to come to terms with the uncertainty factor when they enter the hospital clinic. “It’s the results I’m absolutely terrified of,” another patient said, “not the procedure.”

During this past fall the five of us—all anthropology students at the University of Notre Dame—evaluated the waiting rooms at the Regional Breast Care Center (RBCC). It has been nine years since the waiting room at RBCC last changed, and our ethnographic research focused on determining how to better meet the needs of all who use the space. The director and staff had basic questions whether the waiting rooms still fulfilled the diverse needs of their patients and those who accompany them, and what new things could be done to improve patient satisfaction and comfort.

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Just a Place to Talk: Women and HIV/AIDS

By Christine, Dorian, Kristine, Tom & Vanessa
femme-facade-by-peggy-bonnett-begnaud
Nine months ago, Maria birthed a healthy baby girl. Just two days later, the joyous ecstasy of new life quickly led to a striking reality: Maria’s husband was diagnosed with HIV.

“He thought I was going to leave him, but of course I wouldn’t. We’re in this together.” At the time, she didn’t know quite how personal her statement would become. Just three months later Maria and her newborn daughter were also diagnosed with HIV.

“Initially I was able to handle it in the moment, but then it hits. In time, it’s become much more difficult to deal with.”

Maria certainly feels stigmatized and has refrained from telling her other children. In this Midwestern town, the needs of Maria (a pseudonym) and other women with HIV are ripe with concern and lack of viable opportunity. She told us, “What I, and other women need, is just a place to talk.”

Currently there are HIV/AIDS support groups offered locally through a community center. Our community-based student project, focused on understanding and empowering women suffering from HIV/AIDS locally, brought us to these groups. What we found was a support group for homosexual men that did not offer the support women need.

Through research concerning sexual orientation and HIV/AIDS, we discovered that homosexual men and heterosexual women have different coping mechanisms and symptoms. Women experience more illness as a result to their HIV/AIDS status than homosexual men. They also are more likely to need social support to deal with the pain and fear of being HIV/AIDS positive. (Mosack 2009:137) Although the group that exists can be literally defined as a place to talk, it may not be the best place to be heard and understood as a woman.

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