How Change Happens

Introduction: How Change Happens

WHY DO CERTAIN social changes happen, while others don’t? The answer is not simple. Take smoking. It’s hard to imagine now, but just a few decades ago, walk into a restaurant or fly in an airplane, and every third person could have been holding a cigarette. Just watch an episode of Mad Men to recall how ubiquitous tobacco was. Smoking was synonymous with an American way of life—glamorized by celebrities, promoted in glossy advertisements, and even tacitly endorsed by doctors and nurses, many of whom smoked on the job despite U.S. Surgeon General warnings.

Today, the harmful habit has largely been eliminated. Youth smoking rates have dropped down to 6 percent.¹ For adults, from an all-time high when more than half of men in America smoked, rates have flat-lined to around 15 percent on average.² Tobacco is banned from most places in the United States—offices, airports, malls—and, in some states, even in casinos. Joe Camel has evaporated from youth media, and the Marlboro Man is dead, literally. One of the recognized actors who posed for the ads, Wayne McLaren, died in 1992 (of lung cancer). Smoking today is infrequent, unfashionable, and unwelcome almost everywhere.

The abandonment of smoking is one of the most remarkable societal shifts in modern U.S. history. It has resulted in huge health gains: No other single social change has saved more lives or prevented more disease in the last few decades. How did this landmark achievement occur? How ...