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February 6, 2023

Culture Can Change – Quickly and Profoundly

When in 1986 U.S. Surgeon General Dr. C. Everett Koop announced the goal of a smokefree society by the year 2000, many people wondered what he’d been smoking.

At the time, more than half the adult U.S. population smoked, with much higher rates in many other countries.

Most smokers became addicted, often tenaciously addicted, as children.

A multibillion dollar industry of white collar drug pushers used deceptive advertising, including that purposefully targeting children, to connect smoking with glamour and success, and spent millions to prevent any legislation to put limits on what they could do to push their drug and on what society could do to prevent people from using it anywhere they wanted – including places like airplanes, restaurants, and hospitals.

A “smoker’s rights” campaign funded by Big Tobacco encouraged smokers to get belligerent if asked to refrain from smoking and to frame smoking as a personal right that transcended the right of others to not be poisoned by it.

Today, of course, we do have a smokefree society. Indeed, a smokefree world. I was astonished to see that nobody smokes in airports in Hanoi, Vietnam and Seoul, South Korea.

And we don’t need the police to enforce it – the expectation of never having to suck down someone else’s cigarette smoke has become so engrained in our culture that it is self-enforcing.

This is, I believe, one of the most profound culture shifts in the history of the world.

In the second edition of our book Building a Culture of Ownership in Healthcare (2-time AJN Book of the Year Awardee), Dr. Bob Dent and I describe lessons that you can learn about culture change in your organization from the movement to create a smokefree world and to prevent the white collar drug pushers from working to addict new generations (hey kid, the first one is free). As Founder of STAT – Stop Teenage Addiction to Tobacco – that was the part of the fight I was deeply involved in.

So any time someone tells you that you are wasting your time trying to change the culture where you work, remind them of this profound global sea change in how our cultures treat smoking.

Oh, one more thing: If someone tells you that it takes forever to change culture, that it’s like turning a battleship, ask them how profoundly they think the culture of Twitter has changed in the first few months of Elon Musk’s leadership.