A Tale of Two Stimulants

An Analysis of Newspaper Coverage of Cocaine and Tobacco in Canada

Andrew D. Hathaway (Centre for Addiction and Mental Health)

Patricia G. Erickson (Centre for Addiction and Mental Health)

Abstract: Cocaine and tobacco occupy opposite ends of a legal continuum that is narrowing due to diminishing acceptance of cigarette smoking and increasing restrictions on tobacco sales, use, and promotion. This paper compares Canadian newspaper coverage of the two drugs with reference to the main themes, information sources, and policy positions presented in the late 1980s and late 1990s. Further content analysis, of 1998-2002 opinion-editorials, documents recent developments in print media representations of the debates around use and control of these substances. Most notably, in contrast to earlier drug panics, the authors find a more sophisticated range of perspectives encroaching on the moral-legal distinctions and distortions that mark public discourse on all drugs.

Résumé : L'écart entre la manière dont la loi traite l'utilisation de la cocaïne et celle du tabac est en train de diminuer à cause de l'acceptation réduite du tabac et des restrictions croissantes sur sa vente, son utilisation et sa promotion. Cet article compare la couverture des deux drogues dans les journaux canadiens en indiquant quels en étaient les thèmes principaux, les sources d'information et les prises de position à la fin des années 80 et 90. Une analyse de contenu supplémentaire, d'éditoriaux datant de 1998-2002, recense le développement dans la presse écrite de débats entourant l'utilisation et le contrôle de ces substances. Les auteurs remarquent notamment un éventail de perspectives qui sont plus sophistiquées par rapport aux paniques suscitées par la drogue dans le passé et qui commencent à déplacer les distinctions et distorsions morales/légales typiques du discours public sur toutes les drogues.

Introduction

Cocaine and tobacco share similar pariah status as harmful drugs but from differing social vantage points. While cocaine users have been a small deviant minority, tobacco users have, at least until recently, been part of the acceptable, mainstream majority of society (Beauchamp, 1990; Erickson, Adlaf, Murray, & Smart, 1987). Both drugs are also topical ones that have received considerable attention in the daily press in recent years. Often these journalistic accounts focus on the health risks posed by the ingestion of one or the other of these substances. Such stories can also serve to portray and reinforce negative social stereotypes about the users of tobacco or cocaine (Hadaway & Beyerstein, 1987; Reinarman & Levine, 1989). Some researchers have even suggested that the tobacco addict of the future might occupy a deviant marginalized status comparable to the "narcotic" drug addict of earlier decades (Coambs, Kozlowski, & Ferrence, 1989). Less conspicuous perhaps than in past crusades against opiate, cocaine, and alcohol users, the class-based "status politics" (Gusfield, 1963) of the antismoking movement has also garnered scholarly attention (see Berger, 1986; Tuggle & Holmes, 1997).

Indeed, while cocaine and tobacco still occupy vastly different legal terrain - one criminally prohibited, the other produced and sold commercially - the distance between them appears to be narrowing. The number of public places voluntarily prohibiting cigarette smoking has expanded rapidly, and restrictions are enforced by workplace legislation (Asbridge, 2004). The highly addictive properties of cocaine have long been assumed and perhaps overstated (Erickson & Alexander, 1989). Nicotine's addictive nature by comparison has been well documented only recently (Royal Society of Canada, 1989), even now in the face of tobacco industry opposition, as have the hazards of passive or "involuntary smoking" (United States, Department of Health and Human Services, 1986). Both categorized as stimulants, neither drug can be actively promoted in broadcast media, with tobacco now subject to anti-use messages that rival and surpass in visibility those that have targeted cocaine. The need for drug abuse prevention programs that span licit and illicit drugs and go beyond the classroom is also increasingly recognized (Erickson, 1997; Kozlowski, Coambs, Ferrence, & Adlaf, 1989).

In the field of health communication, the media are a major source of information about drugs and their effects. Images of users may be positive, negative, or neutral. Information about how to prepare and use drugs may also be conveyed. The risks as well as the pleasures of consumption are often presented in considerable detail. Such potential influences contribute to the broader social environment of health promoting or compromising messages and help to shape social norms about appropriate use of substances. Media is able to draw attention to public-health issues that may not be acknowledged or recognized by policymakers, and may provide the support needed for policy action. Media assumes an informed position on the issues it covers by citing authorities and often plays a role in the development of policy by providing the "facts" that inform key decisions (Giffen, Endicott, & Lambert, 1991; Kingdon, 1993; Phillips, Kanter, Bednarczyk, & Tastad, 1991). Print media has been shown, for example, to have significantly influenced the construction of passive smoking as a major social problem in the United States and Canada and a recent spate of smoking bylaw enactments (cf. Asbridge, 2004; Malone, Boyd, & Bero, 2000).

The role of the media in constructing social problems can exist quite separately from objective reporting of scientific facts. "Moral panics" theory (see Cohen, 1972; Goode & Ben-Yehuda, 1994; Young and Cohen, 1981) in particular became popular in the 1990s for explaining the media's role in maintaining the status quo in drug control politics and other social problems arenas. Concurrent efforts by law enforcement and media have at times been suggested to explain the preponderance of exaggerated messages and fear mongering about the harms of alcohol and drug use (e.g., Gusfield, 1981; Reeves & Campbell, 1994; Reinarman, 1988; Reinarman & Levine, 1989). Risk theorists note that social problems have been "scientized" (Beck, 1992), however, such that highly rationalized discourses on risk issues are pervasive and converging on the role of former moral regulation (cf. Hier, 2002, 2003; Moore & Valverde, 2000; Ungar, 2001). Given scientific uncertainties as to the "facts" in many cases, more balance in media coverage and more equal power between rival claims makers is expected (Ungar, 2001).

Sociological conceptions of moral panic and its supporting social relations may also need revising to reflect expansion of the media and the greater number of participants in public-policy debates (McRobbie & Thornton, 1995). In our "multi-mediated" social world, today's "folk devils" (Cohen, 1972) and "outsiders" (Becker, 1963) find themselves articulately defended in the same mass media that castigates them, and their lifestyles promoted in their own niche and micromedia resources. The past decade saw the advent and dramatic expansion of the Internet, putting drug policy subversive information at the fingertips of millions. Despite the ongoing occurrence of media-driven drug scares, there is also now coverage in media from opposing sides of the drug control issue. With news media providing an open forum for debate, the level of public exposure and attention to drug policy issues has achieved a high profile.

Based on content analysis of 1989-90 opinion essays from U.S. newspapers, one study found that drug reform proponents provided significantly more complex arguments than status quo supporters (MacCoun, Kahan, Gillespie, & Rhee, 1993). These authors also note a shift in the debate, from the early 1970s through the 1980s, from decriminalization of marijuana, based on the civil rights of users, to legalization of cocaine and heroin, based on the perceived need to disrupt the connection between drugs and crime. The present paper employs a similar longitudinal perspective, presenting print media coverage of tobacco and cocaine from three daily Canadian newspapers a decade apart. The years 1988 and 1989 were unusual in the high profile given to cocaine and tobacco in Canada. After several years of mild concern about powder cocaine, the summer of 1988 witnessed the introduction of the "crack menace" to the general public (Cheung, Erickson, & Landau, 1990). That same year, the province of Ontario introduced an Act to restrict smoking in the workplace.

In 1989, the federal government passed the Tobacco Products Control Act, which was to phase out all tobacco advertising and require additional health warnings on packages and package inserts. This period of high awareness of these two substances spurred the collection of data (by Erickson) on the coverage of cocaine and tobacco in Toronto newspapers in 1988-89 (Erickson & Moreau, 1990). Replication of this research using data from the same Toronto newspapers one decade later (1998-99) provides us with a basis for comparison. Further content analysis of opinion-editorials appearing in the past five years (1998-2002) augments our inquiry as to ongoing developments in print media representations of drug issues.

Methods

In 1988-89, Canada's largest city, Toronto, had two local major daily newspapers (the Toronto Star and the Toronto Sun) and one paper that is national in the scope of its reporting (the Globe and Mail). The Star and Sun are often characterized in terms of their distinctive political slant on social issues, one more liberal and the other more conservative, respectively. The Globe and Mail is well regarded for its even-handed, factual reporting of the news and widely touted as Canada's "newspaper of record." Accordingly, taken together these three high-circulation dailies in Toronto, though unlikely representative of newspapers across the nation (or Western societies in general), provide insights into the spectrum of Canadian print media reporting on drug issues.

Using a design comparable to Chapman's (1989) study of tobacco coverage in Australia, data were collected in 1990 for the 24-month period January 1, 1988 to December 31, 1989. All stories appearing in the Sun, Star, and Globe that dealt with cocaine (in any form, including crack) or tobacco (including cigarettes, cigars, snuff, and pipe tobacco products) were grouped in a classification scheme emerging from the data in each item. The content in each story was assessed for central theme, sources of information, mention of adverse health effects, and policy stance, if any, on the issue of control. Pretesting of the coding schedule, with 10 examples of stories on each drug assessed by two independent coders, was used to establish schedule reliability. A senior research assistant then conducted all data extraction from the original sources (N=150). In 2002, the same coding scheme was applied to articles appearing in the same three Toronto newspapers from January 1, 1998 through December 31, 1999 (N=126).

The later sample was identified by searching the DrugNews on-line database of drug articles (http://www.mapinc.org/drugnews/) collected from newspapers and magazines around the world (though predominantly from the United States and Canada). Although not fully inclusive and covering only the past few years, the collection allows for media searches that would be much more difficult to conduct using more traditional source-specific on-line or CD-ROM searches (Erickson & Haans, 2000). Whereas data collection by means of this database is not strictly comparable to the manual search of original sources conducted 12 years earlier, this time- and cost-effective automated method gives no expectation of systematic bias in the sample of articles identified.

The on-line automated search of the three Toronto newspapers turned up 126 articles from 1998-99 that were centrally related to cocaine (N=98) or tobacco (N=28). Coding followed the same schedule that was used to examine 150 articles (83 tobacco and 67 cocaine) from 1988-89. Our content analysis compared stories on the two drugs from one decade to the next in terms of the central themes presented, information sources cited, adverse drug effects mentioned, and policy stances taken or inferred. Each article was read and analyzed for the major theme referred to or implied as well as any other issues that could be discerned in the story (cf. Chapman, 1989; Lima & Siegel, 1999; MacCoun et al., 1993; Menashe & Siegel, 1998).

In developing the mutually exclusive content categories, our aim was to develop meaningful ways to capture and contrast the portrayal of both legal and illegal drugs. In the past, the legal status of a drug has been a major determinant of content of media stories. For example, drug panics favour the presentation of crime-related issues, the extreme deleterious nature of the drug in question, the imminent spread of the "epidemic" to mainstream society, and the need for more punitive criminal controls (Goode & Ben-Yehuda, 1994). In contrast, stories about legal drugs such as alcohol and tobacco have been prone to deal with issues of regulatory control, taxation, health effects, and youthful vulnerability (Mitchell, 1990). The traditional addictions literature, moreover, identifies three modes of intervention for drug abuse problems: prevention, treatment, and enforcement. A more recent addition is the public-health response that is focused on achieving "harm reduction" (MacPherson, 2000). Our interest was in determining whether there would be a sharp demarcation in the types of themes related to cocaine, the feared and criminalized substance, and those related to legally available tobacco.

Eight major themes were coded with the following descriptors: (1) Cessation/Treatment; (2) Civil/Constitutional Rights; (3) Crime/Smuggling/Distribution; (4) Education/Awareness/Prevention; (5) Health Effects/Consequences; (6) Criminal Justice/Law Enforcement; (7) Legislation/Policy/Taxation; and (8) Prevalence Statistics. In addition to the major theme of the story (most often appearing in the headline or first few paragraphs of an article), up to five other issues were found in some articles, though the majority contained no more than two or three issues in total. To account for those stories with multiple issues, each theme's count was then calculated in proportion to all other issues appearing in the articles we analyzed.

The importance of "claims makers" in the moral panics literature directs attention to the sources of information in media stories. Although spokespersons need not advocate a discernible position, we grouped the sources cited to reflect their spheres of interest, expertise, or control in drug matters. Sources of information in the stories we analyzed broke down into five distinct groupings: (1) Civil/Criminal Justice Officials; (2) Government Bureaucrats/Politicians; (3) Law Enforcement Officials/Police; (4) Lobby Groups; and (5) Science/Health/Research Professionals. All first and subsequent sources of information were coded in their order of appearance in the article. Up to seven different information sources were found in some cases, but the number of sources in most stories was no more than one or two. To account for the higher number of informants in some articles, we calculated the prevalence of each informant group as a proportion of the total information sources cited.

Stories also were all coded for the adverse drug effects they mention (e.g., overdose, addiction, health problems, or disease), and the "stance" of each with reference to drug policy. Each story was fit into one of five categories - All Positive, More Positive than Negative, Neutral or Not Related to Controls, More Negative than Positive, All Negative - on the basis of its stance, directly stated or inferred, toward increasing controls on cocaine or tobacco (i.e., by new legislation, more enforcement, et cetera). In support of the foregoing theoretical discussion, more balanced reporting is evident in the later sample of drug stories. The predominant stance of neutrality (and non-control-related content) we found in the 1998-99 articles prompted our analysis of recent opinion-editorials that express a clear opinion on control.

Although the question of how editorial boards and commentators are framing the debate differs from the analysis of actual news articles, it is another important indicator of the form, content, and representation of policy discussions in print media. Unlike "hard news," opinion discourse problematizes, prompting others to take sides and revealing the normative dimension of news issues (cf. Greenburg, 2000; Hessing, 2003). Supplementing our initial content analysis is a more qualitative look at related opinion pieces (feature columns, op-eds, and letters to the editor) published in the Globe and Mail over the five-year period 1998 through 2002.

Findings

A comparison of coverage in two time periods: 1988-89 and 1998-99

Tobacco: The 1988 introduction of an Act in Ontario to restrict smoking in the workplace explains the high coverage that year of tobacco issues and of tobacco legislation in particular. Table 1 shows that central themes relating to policy were more than twice as prevalent in 1988-89 as compared to 10 years later (61.4% versus 28.6%). Articles appearing in 1998-99 attend to health consequences with more regularity (25% versus 14.5%), with more attention to education, prevention, and the prevalence of smoking, more concern for justice and law enforcement issues, and less concern for policy per se (Table 1 and Table 2).

Table 1: Comparison of central themes
1988-89 1998-99
Central Theme: Tobacco

Tobacco

%

Cocaine

%

Totals

Tobacco

%

Cocaine

%

Totals

Cessation/Treatment

8

9.6

0

0.0

8

0

0.0

5

5.1

5

Civil/Constitutional Rights

2

2.4

1

1.5

3

0

0.0

1

1.0

1

Crime/Smuggling/Distribution

4

4.8

24

35.8

28

1

3.6

36

36.7

37

Education/Awareness/Prevention

4

4.8

6

9.0

10

2

7.1

1

1.0

3

Health Effects/Consequences

12

14.5

11

16.4

23

7

25.0

10

10.2

17

Criminal Justice/Law Enforcement

1

1.2

21

31.1

22

8

28.6

16

16.3

24

Legislation/Policy/Taxation

51

61.4

0

0.0

51

8

28.6

23

23.5

31

Prevalence Statistics

1

1.2

4

6.0

5

2

7.1

6

6.1

8

Totals

83

99.9

67

99.8

150

28

100

98

99.9

126

The prominence of justice-related issues in the later period is due mainly to publicity surrounding a spate of proposed lawsuits by provincial health ministries to recoup health costs from tobacco companies in Canada. Following on the heels of a multibillion-dollar court settlement against U.S. "big tobacco," this period of litigious posturing in Canada was short-lived and soon dissipated. Although receding with respect to total sources cited (from 50.4% to 25.6%), government officials remained the first source of information on tobacco, even while lobby groups (i.e., anti-smoking coalitions and tobacco industry spokespersons) and health professionals gained prominence as primary media informants (Table 3 and Table 4).

While cancer and respiratory problems retained a high yet diminishing profile in the adverse health effects mentioned, by the late 1990s tobacco's addictive nature had emerged as a predominant concern in its own right (Table 5). Contrary to the earlier sample of stories, nearly half of which (45.7%) supported tighter restrictions, for 1998-99 the vast majority (71.4%) were neutral or unrelated to control, with just as many (~14%) opposed as in favour of increasing controls on tobacco (Table 6).

Cocaine: Focus on the crimes of cocaine smuggling and distribution was a consistent central theme in both the late 1980s (35.8%) and the late 1990s (36.7%), but drug legislation emerges in the latter period as an overarching issue that subsumes such components as health and criminal justice (Table 1). Within the broader scope of total issues raised, Table 2 shows that crime, criminal justice, and law enforcement likewise wane (from 37.9% to 21.8% and 27.9% to 20.8%, respectively) in comparison to policy (1.1% to 12.9%), drug treatment (1.1% to 10.4%), and respect for the civil rights of users (1.6% to 6.9%). Themes around health effects (~14%), prevalence (~8%), and education/prevention (8.4% to 5%) remained relatively constant in terms of their overall coverage.

Table 2: Comparison of total issues raised
1988-89 1998-99
Total # Issues Involved:

Tobacco

%

Cocaine

%

Totals

Tobacco

%

Cocaine

%

Totals

Cessation/Treatment

10

4.5

2

1.1

12

1

1.3

21

10.4

22

Civil/Constitutional Rights

12

5.4

3

1.6

15

0

0.0

14

6.9

14

Crime/Smuggling/Distribution

5

2.3

72

37.9

77

3

3.9

44

21.8

47

Education/Awareness/Prevention

18

8.1

16

8.4

34

13

16.9

10

5.0

23

Health Effects/Consequences

46

20.7

27

14.2

73

19

24.7

29

14.4

48

Criminal Justice/Law Enforcement

18

8.1

53

27.9

71

12

15.6

42

20.8

54

Legislation/Policy/Taxation

101

45.5

2

1.1

103

19

24.7

26

12.9

45

Prevalence Statistics

12

5.4

15

7.9

27

10

13.0

16

7.9

26

Totals

222

100

190

100.1

412

77

100.1

202

100.1

279

Table 3: Comparison of top information sources
1988-89 1998-99
First Source of Information:

Tobacco

%

Cocaine

%

Totals

Tobacco

%

Cocaine

%

Totals

Civil/Criminal Justice Officials

2

3.4

13

22.0

15

2

7.7

12

14.6

14

Government Bureaucrats/Politicians

29

50.0

15

25.4

44

10

38.5

12

14.6

22

Law Enforcement Officials/Police

3

5.2

26

44.1

29

0

0.0

34

41.5

34

Lobby Groups

8

13.8

4

6.8

12

6

23.1

5

6.1

11

Science/Health/Research Profs.

16

27.6

1

1.7

17

8

30.8

19

23.2

27

Total

58

100

59

100

117

26

100.1

82

100

108

Given the consistency of health-related content, the enhanced role of health professionals as media informants (1.7% to 23.2% and 6.3% to 24.4%, Table 3 and Table 4, respectively) may be attributed to new treatment and public-health initiatives (e.g., needle and syringe exchange programs) to cope with rising intravenous drug use. Indeed, while addiction remained the primary adverse health effect mentioned, in 1998-99 injection overdose, HIV, and hepatitis accounted for 40% of such mentions (Table 5). Despite all the attention to drug legislation and the impact of drug laws on public-health outcomes, however, Table 3 and Table 4 show that law enforcement officials lost no ground as the most often cited source of information (from 44.1% to 41.5% and 33.3% to 35.3%, respectively), with less input now apparent from politicians and bureaucrats.

The new context of discussion, favouring greater access to treatment and harm-reducing health initiatives, becomes most apparent in the observed shift in stances from majority support (52.2%) for increased controls on cocaine in the "crack era" (1988-89) to next to no support (4%) for this position in 1998-99 (Table 6). As similarly noted with tobacco, most cocaine stories (77.6%) from the latter period were deemed neutral or unrelated to control. This more measured stance might reflect the fact that controls could not have been much tougher in the post-crack era. Alternatively, perhaps it indicates greater appreciation on the part of journalists as to the complexity of drug issues.

Table 4: Comparison of total information sources
1988-89 1998-99
Total Sources of Information:

Tobacco

%

Cocaine

%

Totals

Tobacco

%

Cocaine

%

Totals

Civil/Criminal Justice Officials

3

2.7

26

23.4

29

4

9.3

22

18.5

26

Government Bureaucrats/Politicians

57

50.4

35

31.5

92

11

25.6

17

14.3

28

Law Enforcement Officials/Police

5

4.4

37

33.3

42

0

0.0

42

35.3

42

Lobby Groups

22

19.5

6

5.4

28

15

34.9

9

7.6

24

Science/Health/Research Profs.

26

23.0

7

6.3

33

13

30.2

29

24.4

42

Total

113

100

111

99.9

224

43

100

119

100.1

162

Table 5: Adverse health effects mentioned
1988-89 1998-99
Adverse Health Effects:

Tobacco

%

Cocaine

%

Totals

Tobacco

%

Cocaine

%

Totals

Cancer

12

52.2

0

0.0

12

4

30.8

0

0.0

4

Respiratory/Heart Conditions

11

47.8

3

33.3

14

3

23.1

0

0.0

3

Addiction

0

0.0

6

66.7

6

6

46.2

33

60.0

39

Overdose

0

0.0

0

0.0

0

0

0.0

6

10.9

6

Hepatitis/HIV

0

0.0

0

0.0

0

0

0.0

16

29.1

16

Total

23

100

9

100

32

13

100.1

55

100

68

Table 6: Stance toward increased controls
1988-89 1998-99
Stance toward Increased Controls:

Tobacco

%

Cocaine

%

Totals

Tobacco

%

Cocaine

%

Totals

All Positive

31

37.3

35

52.2

66

2

7.1

2

2.0

4

More Positive than Negative

7

8.4

0

0.0

7

2

7.1

2

2.0

4

Neutral or Not Related to Controls

26

31.3

29

43.3

55

20

71.4

76

77.6

96

More Negative than Positive

8

9.6

1

1.5

9

1

3.6

2

2.0

3

All Negative

11

13.3

2

3.0

13

3

10.7

16

16.3

19

Total

83

99.9

67

100

150

28

99.9

98

99.9

126

Public health and law enforcement

Despite their differing legal status, the addictive properties of nicotine and cocaine present similar drawbacks from a public-health perspective. Indeed, addiction was the most commonly mentioned feature of cocaine in both time periods, in at least 60% of stories mentioning health effects (Table 5). In contrast, no stories included such a reference for tobacco in the 1980s, though nearly half (46.2%) did so a decade later. This suggests that the predominant association of addiction with the illicit drugs was undergoing a transformation to a more scientifically accurate designation of addiction as related to both illicit and licit drugs, despite continuing resistance by the tobacco industry. Not surprisingly, adverse health effects such as cancer and respiratory conditions were associated much more with tobacco than with cocaine, although some coverage of heart problems due to cocaine was mentioned in the first era.

By the second era, recognition of cocaine's role in overdose deaths and HIV/hepatitis transmission was also recorded. Overall, the health consequences for tobacco raised in both periods made up more than one-fifth of all topics covered (20.7% to 24.7%) and for cocaine more than one-sixth (~14%) (Table 2). Related concerns with more specific forms of prevention and treatment were mentioned less frequently than health effects for both drugs, but prevention content increased for tobacco (from 8.1% to 16.9%), and treatment content for cocaine (from 1.1% to 10.4%), between the first and second time periods. Overall, then, health consequences and effects of both drugs seem to have had substantial coverage in both eras.

At the same time, however, allusions to crime and drug smuggling predominated in cocaine stories for both the 1980s and the 1990s periods in up to nearly 38% of both central themes and total issues (Table 1 and Table 2). The only exception was a decline to 21.8% of all issues in 1998-99, but this topic was still the number one ranked content area for cocaine. For tobacco, less than 5% of themes or total issues involved the category of crime and drug distribution, despite the well-known concern among Canadian officials of cross-border tobacco smuggling from the lower-priced U.S. market. Specific law enforcement and justice system issues were more evenly divided between the two drugs, though cocaine has tended to dominate.

In keeping with this emphasis on the response to a prohibited substance such as cocaine, police and other criminal justice officials were much more likely to be information sources for cocaine stories, more than half the combined total, but almost never for tobacco (Table 4). Bureaucrats and politicians and science/health professionals were more likely to be cited in tobacco stories, though they were not absent from the cocaine issue. In sum, this section has highlighted overarching trends in health and enforcement in the coverage of cocaine and tobacco. The topics and sources presented did not reflect the extremes found in their polar opposite legal status, though the emphasis was where it would be expected. Put otherwise, merging of health and addiction concerns was evident for both drugs, despite the criminal justice focus in a majority of cocaine stories.

Newspaper commentary: 1998 through 2002

As noted earlier, the high prevalence of 1998-99 news articles that were deemed either neutral or unrelated to control prompted us to examine opinion pieces appearing in the Globe and Mail, Canada's widest circulation national newspaper, between 1998 and 2002. Search of the DrugNews database for feature columns, op-eds, and letters to the editor featured in that five-year period turned up 55 articles that mention cocaine or tobacco (or both drugs). Selected excerpts illustrating the most representative policy positions and opinions are included below to round out our analysis.

Of 25 opinion pieces related to tobacco, it is especially noteworthy that none argue in favour of increased controls. Contentions as to the propriety of regulations are largely absent, with no arguments for banning tobacco despite its well-recognized harms. The health hazards posed by cigarette smoking were a prominent theme in about half (48%) of the articles examined. Most markedly, we found that the list of harms presented (ordinarily alongside the hazards of drinking alcohol) was often raised in unfavourable comparison to health problems associated with illicit forms of drug use. In the context of arguments for illicit drug reform, typical statements in this vein include the following:

[O]ur society remains obsessed with the 'danger' of hard drugs - substances that probably do not harm or kill as many people as do alcohol or tobacco. (Globe and Mail, letter to the editor, March 5, 1998, p. A19)

There are a number of addicting drugs that are legal, notably tobacco and alcohol, and a large number that are not, notably opiates. Tobacco causes cancer, heart disease, pregnancy complications, etc. Alcohol causes cirrhosis, several brain diseases, pregnancy complications, etc. Opiates cause none of these. (Globe and Mail, letter to the editor, April 11, 2002)

The real war on drugs, if you look at the statistics, is a war against marijuana, a substance less harmful than tobacco or alcohol. (Globe and Mail, column, July 26, 2000)

Like this writer, several others make the point that some prohibited drugs (particularly cannabis) are far less harmful than tobacco (or alcohol). Suggestions that the latter legal substance(s) be banned to redress this imbalance are raised only satirically, however, as in these illustrations, as a rhetorical device to underscore the folly of drug prohibition. In often sardonic tones, these commentators argued:

Let's outlaw tobacco. Let's bring back prohibition. Or, rather, let's keep our heads well and truly in the sand in the belief that by calling two addictive drugs [tobacco and alcohol] permissible and manageable, we have the problem licked. Let's ensure a fair place in society for the criminals who run the drug trade. (Globe and Mail, letter to the editor, July 19, 2001, p. A16)

If cannabis were as addictive as tobacco, as criminogenic as alcohol … it would make less sense to abdicate its distribution to black marketeers who sell on commission to anyone of any age, any time, anywhere, no questions asked. (Globe and Mail, letter to the editor, August 6, 2001)

Tobacco is an extremely addictive substance whose long-term use can have devastating medical consequences.… I suppose if we banned tobacco use … this would at least be consistent with the rules for marijuana, but there is an alternative. Treat adults like adults. Allow them to ingest any recreational mood-altering substances they like, but by all means warn them in an intelligent, respectful way about any associated health risks. (Globe and Mail, letter to the editor, August 14, 2001)

Although prohibiting tobacco, in public-health terms, may be just as tenable as the more liberal reforms they proposed, commentators seemed at least implicitly aware of the historical legacy of problems attending prohibition or excessive regulation. Widespread recognition in Canadian experience that cigarette tax hikes and tighter restrictions encourage smuggling and black market distribution, for example, might account for the prevalence of arguments in favour of public health and education as needed policy alternatives. Specific recommendations for reform ranged from moderate proposals to decriminalize marijuana to outright legalization of all drugs. Most often expressed were more common concerns to correct the inconsistencies of existing legislation and move toward rational scheduling informed by both the harms of drug use and harm due to policy. Accordingly, they argued:

The solution is to legalize drugs.… Repeal the huge sin taxes on liquor and tobacco. Eliminate the conditions of high risk that make it possible for the brutal and reckless to monopolize the vice industries and drive up prices. (Globe and Mail, op-ed, January 10, 2001)

The easiest, fastest, and cheapest way to deliver a crippling blow to organized crime is to eliminate the profits by legalizing the use of all recreational drugs, and regulating and taxing them as we do tobacco and alcohol. We may have no love for tobacco companies, but they are far more under government control than any biker gang, and they pay taxes, and can be sued as well. (Globe and Mail, letter to the editor, August 26, 2002)

Imposing a fine may be necessary to signal Canada's official disapproval of marijuana and concern about its effects; but the penalty should be no more than that, to be proportionate in a country where hazardous materials (tobacco) and drinks with frequently lethal effects (alcohol) are widely and legally available. (Globe and Mail, editorial, December 16, 2002)

Extending our analysis to include Globe and Mail opinion-editorials (N=30) that mention cocaine in 1998 through 2002, we found that two-thirds make clear arguments for drug policy reform, with discussed options this time ranging from highly specific calls for harm reduction initiatives and funding for treatment to general reform and decriminalization of all drugs. Standard statements of the more general anti-prohibitionist variety include the following:

Ending prohibition makes common sense. Instead of propping up an enormously profitable black market in drugs, and pushing drug users to the margins of society, governments could focus on productive ways to control the harmful use of substances, be they alcohol, tobacco, marijuana, heroin or cocaine. They could turn away from soul-destroying prisons and toward understanding drug use as a natural, not deviant, part of human behaviour. (Globe and Mail, op-ed, June 9, 1998)

The laissez-faire attitude toward cannabis possession offers a model that could be extended to all drugs, including those much more dangerous than cannabis. Such a move would stir the accusation that the people most vulnerable to drugs were being abandoned to predatory drug dealers. Yet for those drug users who want to snort cocaine or inject heroin, the real hazards might be no greater than under the status quo. Why? Because most empirical evidence indicates that if a person really wants drugs, of whatever type, he or she will be able to get them. If it is accepted that drugs are a social ill that can never be eradicated, the door opens to a much more selective brand of law enforcement than currently prevails. (Globe and Mail, editorial, August 21, 2001)

Like them or hate them, drugs already swirl all around us. Ask any teenager. The 'war on drugs' … has ultimately proved as futile and destructive as Prohibition. The only alternative is damage control - harm reduction, and not merely in a strictly physical sense. Every sociologist knows that the more a person is exposed to crime, arrest and imprisonment, the worse his or her long-term prospects. Decriminalizing simple drug use would reduce that exposure significantly. Such a radical move, fraught with uncertainty, offers no simple antidote to the drugs plague. But two, five or 10 years hence, the results might be a lot better than what we see around us now. (Globe and Mail, editorial, August 23, 2001)

The case for harm reduction as a pragmatic public-health perspective emerged recurrently in these reform-oriented statements. Although the term "harm reduction" is not always used per se, the routine occurrence of public-health arguments suggests its diffusion, in less than a decade, from early "grassroots" support and academic origins (see O'Hare, Newcombe, Matthews, Buning, & Drucker, 1992) to current mainstream forums and acceptance "by most experts." The statements below illustrate this propagation.

The lessons from Europe and Australia are compelling. Drug control policies should focus on reducing drug-related crime, disease, and death, not the number of casual drug users. Stopping the spread of HIV by and among drug users by making sterile syringes and methadone readily available must be the first priority. (Globe and Mail, op-ed, June 13, 1998)

Canada must reassess its current orientation to the problem of injecting drug use and HIV/AIDS. Stakeholders must endorse a 'harm reduction' approach which views drug dependence as a public health problem. Such an approach reduces the likelihood that drug users will contract or spread HIV and other diseases. It lessens the possibility that they will overdose on drugs of unknown purity or potency. A public health approach tries to stem unsafe methods of injection, to decrease the rate of drug consumption, to reduce experimentation with drugs most likely to cause medical problems, and to help users to obtain treatment. (Globe and Mail, op-ed, December 1, 1999)

[Citing testimony by a witness before Canada's Special Senate Committee on Illegal Drugs] "It is hard to imagine policies better suited to generating and perpetuating violence, corruption, organized crime, destruction of civil liberties, needless death, misery and social dysfunction than the prohibitionist schemes that Canada's policy makers and Parliamentarians have promoted for the last 90 years." There is a different method that has now been accepted by most experts: It's called 'public-health approaches' centered on 'harm reduction.' (Globe and Mail, column, January 10, 2001)

Despite its official endorsement in Canada's Drug Strategy and increasingly mainstream acceptance, however, support for harm reduction in actual practice is far from unequivocal. While Canada's first needle exchange program dates to 1988, such public-health measures are still highly controversial. Opponents say that tolerating substance abuse facilitates addiction and sends the wrong kind of message. More recently, proposed safe-injection sites have met the same cold reception (although one did open in Vancouver in September 2003). Thus, although widely palatable as a pragmatic solution in theory, the "devil in the details" of harm reduction in practice keeps initiatives at bay in many places. Statements respectively for and against a plan to establish Canada's first official safe-injection site follow:

A safe-injection site would not reduce crime. It would not stop people from turning to drugs, though it might help them to stop taking them. But it would provide a clean medically supervised place for addicts to go to inject their illegal drugs, mainly heroin and cocaine. And, as it has shown signs of doing at sites long operating in Switzerland, Germany and the Netherlands, it might relieve some of the harm the addiction causes. (Globe and Mail, editorial, November 15, 2002)

[Former addict, now director of street services for youth] John Turvey doesn't think much of safe injection sites for drug addicts. He thinks the 'harm-reduction initiatives' that are all the rage in health-policy circles these days are likely to add to the harm, not reduce it. Ask him what Vancouver's wretched drug community needs most, and he'll tell you tougher enforcement and more policing.... [H]e figures safe injection sites will help make Vancouver's Downtown Eastside an even bigger magnet for addicts than it already is. And with more addicts come more traffickers, loan sharks and other criminals.… The good news is that drug deaths in Vancouver have fallen sharply.… The decline, says Mr. Turvey, is due not to the progressive treatment of addicts but to some major drug busts, which got some of the traffickers off the streets and dried up access to hyper-pure narcotics. "I think harm reduction has been a blessing for academics and the medical community … makes them feel they have a purpose in life." In other words, a quick fix. Too bad it won't work. (Globe and Mail, column, November 19, 2002)

Beyond the call for drug reform and development of arguments primarily aligned with harm reduction, the next most prevalent theme running through opinion pieces decried certain aspects of current or proposed drug enforcement legislation. Prominent among the complaints were alleged abuses of the law by criminal justice officials and police practice in the conduct of drug investigations. The following examples target Ontario's crime proceeds legislation and a federal law permitting police to grow, manufacture, traffic in, and/or sell illegal drugs in the course of conducting a criminal investigation (Controlled Drugs and Substances Act). The observations below specifically target civil forfeiture and state-sanctioned police entrapment.

The ultimate justification offered for these legal atrocities [police seizures of bank accounts as proceeds of alleged crimes] is that they are necessary to combat those filthy-rich alien narco-barons. In reality, time after time, serious researchers have demonstrated that the underworld consists overwhelmingly of informal networks of small-time operators with short career life expectancies.… Thus civil forfeiture will continue to fill government coffers with the trailer homes, cars and motorboats of ordinary citizens, many of them innocent, with no sign of the narco-baron's yachts or gold-plated bathtubs. (Globe and Mail, op-ed, August 29, 2000)

This law [proposed Bill 155, Remedies for Organized Crime and Other Unlawful Activities Act] threatens to transform policing into a self-contained, self-perpetuating little industry, hooked on the proceeds of vice just like any addict, putting occasional pressure on organized crime but never enough to derail the gravy train. If it were anyone other than the government doing this, we would call it a protection racket. (Globe and Mail, op-ed, January 10, 2001)

Canada - a country where people care so much about human rights that some of them will risk pepper spray in the eyes merely to protest against the presence of a visiting politician from a land without such rights - is now the only nominally civilized nation on Earth in which police are allowed to tempt people into criminal activity and then arrest them for it. Just as the public is finally noticing that the War On Drugs has been a disaster, it has been deemed sufficient excuse to suspend civil liberties here. (Globe and Mail, op-ed, October 19, 1998, p. A15)

As the latter quote above most clearly demonstrates, the theme of rights protection for drug users and offenders was a prominent feature of these articles. The following selection of examples in this category reinforces the civil rights theme with reference to drug testing, unlawful arrest, search, and seizure. Of particular note in these illustrations is their subversion of the premise of "us versus them" (Hathaway, 2002) or discourse of the "other" found in media portrayals (cf. Cohen, 1972; Fowler, 1991; Giulianotti, 1997; Greenburg, 2000; Hall, Critcher, Jefferson, Clarke, & Roberts, 1978), by recognition that infringing civil liberties in the name of drug enforcement compromises the basic rights of all Canadians. Accordingly, they argue:

So [then Ontario premier] Mike Harris wants to give welfare recipients drug tests. Well, the rich have addiction problems, too. Why doesn't Mr. Harris test for debilitating alcohol and cocaine problems before advancing privileged Ontarians the tax rebates and tax reductions that he continues to slather on them? If we're going to put public funds into social engineering, let's make it work at both ends of the spectrum. (Globe and Mail, letter to the editor, November 16, 2000)

The connecting thread [between police charges overturned against an alleged crack smoker and drunk driver, respectively] is that it is not good enough for police to detain and search people simply because they seem suspicious. Under the law, there must first be 'reasonable and probable grounds' for doing so. As both judges made clear, the law means exactly what it says.… It is not hard to feel empathy for the police and their motives in cases such as these. Few citizens question the importance of cracking down on drunken driving. Few would want a crack house in their neighbourhood. Yet, there is a larger issue: Canadians' protection against arbitrary arrest. (Globe and Mail, editorial, April 16, 2001)

It is in the nature of rights that when an alleged drug trafficker's rights [to protection against unreasonable strip searches] are at issue, so too are the rights of protesting university students, or any other citizens who for whatever reason run afoul of the law. (Globe and Mail, editorial, December 8, 2001)

Discussion

In modern Western society, the democratic distribution of knowledge and rational dialogue of an informed public through a diverse media has long served as a political ideal. Contrary to the ideal, however, studies of the media over the past 20 years reveal the inherent limits to political dialogue in news media and its contributing role in the reproduction of hegemony - the existing structure of knowledge-power-control relations in society (Ericson, Baranek, & Chan, 1987). In our "administered society," it is argued, the media work to reflect the dominant ideology, acting to provide a stable "symbolic canopy" (Berger & Luckmann, 1966) in the face of cultural pluralism (cf. Grenier, 1992; Hall et al., 1978).

In moral panics theory this process is abetted by the scapegoating of drug users and other categories of "folk devil" (Cohen, 1972), onto which deeply rooted social fears and anxieties are projected. Folk devils are less marginalized than they once were, however. The contemporary reality of dealing with social difference has ushered in an era wherein a multitude of voices command media attention and contribute to the shape of public-policy debate. Different mass and micromedia offer disparate perspectives, with diverse niches of opinion and identity represented. The proliferation and diversification of these media in recent years have ensured that moral panics are now continually contested (McRobbie & Thornton, 1995).

Contestation and balance may also be more likely with "scientized" conceptions of morality emerging. The sites of social anxiety appear to be transforming as post-moral designations of risk and deviance converge (Hier, 2003; Ungar, 2001). As risk profiling produces targets for public-health policy, new forms of social control become evident. Assigning blame to drug users as a high-risk group for health problems, and a vector of contagion to the larger society, provides a strong rationale for their stigmatization (cf. Coughlin, 1998; Douglas, 1992). Yet the call for harm reduction emanates from many quarters beyond the field of public health, most notably from advocates of more liberal drug policies and interest groups that represent drug users. Our findings as to the complexity of drug reform discourse corroborate those of MacCoun and his colleagues (MacCoun et al., 1993). With both public-health and civil rights-based arguments now prominent, moreover, the debate seems destined to become ever more complex.

It remains to be seen whether this level of rhetorical sophistication will politically help or hinder the drug reform movement. One question that can be considered is whether the content of such stories may influence the public's perception of appropriate policy responses to drug control issues.

In a recent editorial, the international journal Addiction declared that the mass media would be the drug war's "next battleground" (Proctor & Babor, 2001). If this is to be the case, is there any evidence of a shift to harm reduction alternatives? Canada's Drug Strategy adopts harm reduction as its official aim, but the new federal drug law of 1997 has been criticized for continuing harsh prohibition for illegal drugs such as cocaine and cannabis (Hathaway & Erickson, 2003). Nevertheless, if a greater credibility for a less punitive, public-health response is displayed in public discussion, this step may also set the stage for more tangible legal reform.

The greater policy sophistication, with less emphasis on criminal justice responses, occurring in opinion pieces over the past five years suggests that this process may be under way already. Moreover, harm reduction is also described as an integrating perspective for legal and illegal drugs (Erickson, 1999; Single, 1997). Both tobacco and cocaine were increasingly described in this analysis in terms of addictive properties and adverse health effects. Even if the term "harm reduction" is not specifically mentioned in the media stories, the need for appropriate controls while minimizing adverse health effects suggests that the media have performed a crucial dissemination function for the promotion of a harm reduction stance to both these stimulant drugs.

Acknowledgments

The authors appreciate the helpful comments of John Langer, and two anonymous reviewers assigned by the Journal, on earlier drafts of this paper. We also acknowledge the invaluable contribution of Joan Moreau to the first wave of data collection and analysis. All views expressed are those of the authors, not CAMH.

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