Thank you for sharing that

Thank you for sharing that

Tin can phones, CC BY

Tin can phones, CC BY

I was just finishing up an in-depth individual interview for our LGBTQ Adults and Tobacco Stigma study. I announced that I had one last question. “Do you have any feedback for me about the interview or the study?” We sometimes get responses like, “The survey was too long,” or “You didn’t ask me enough about [a specific topic]. This participant, a woman about my age, a lesbian of color, responded differently. “No. It was really good,” she said. “I didn’t feel uncomfortable at all.” She said this with an inflection of surprise. I paused for a moment. This was the first time during the interview that I really didn’t know what to say. I wanted to say something like, “That makes me really happy to hear, because it’s profoundly important for me as a researcher and as a person to affirm the dignity of others as they share their stories.” Instead, I responded with a weak, “Thank you for sharing that.”

But I knew in that moment that there was so much more to her statement. I wanted to begin the interview all over again. I wanted to know why she was so surprised that she had not been made to feel uncomfortable. I wanted to know when, where, how often she finds herself in situations where she is being paid to share her stories and experiences and thoughts, but feels uncomfortable doing so. I wanted to know why she chose to share that observation with me. As a researcher, I could have responded with, “Tell me more about that” or even “Have there been times when you did feel uncomfortable?” Instead, I responded with a weak, “Thank you for sharing that.”

Our study investigates not just tobacco-related stigma, but also various ways in which people who have been marginalized experience stigma in other aspects of their lives. In this moment, I was reminded, as a researcher and as a person, how important it is to affirm each person’s story. But I was also reminded how easy it is to silence a person simply because you are not quite sure how to ask them to say more.

Photo elicitation

Photo elicitation

Beginning in October 2014, our team at the Center for Critical Public Health set out to investigate how gender overlaps with ideas around alcohol use. Using an interview-based approach, we’ve now interviewed roughly one hundred and sixty 18-25 year-olds living in the Bay Area. As part of our interview schedule, we created a photo elicitation activity, where participants are asked questions based on photographs presented by the interviewer. For the next few months we piloted different types of images, ranging from advertisements to candid images found on open source image sites. We’ve used multiple photos since the start of the project; some were dropped along the way, and a few have been altered to examine specific ideas of interest. The photo elicitation activity has proven to be a helpful strategy for discussing gendered issues with participants who are reluctant to talk about gender differences during the normal question-answer sections of our schedule.

Two items of particular interest were pivotal in designing our photo elicitation activity:

1) Participants gave particularly interesting responses to a Facebook-embedded photo we were using, and

2) Participants were generating a significant amount of discussion around their own social media use.

Since social media seemed both interesting and relevant to so many of our participants, we decided to embed some of our photographs into different social media platforms, creating both an Instagram and Snapchat photos. As the project continued, our discussions regarding participants’ social media use were unique enough that we expanded the interview schedule to include specific social media questions in the open-ended portion as well. The following is a summary of findings that have emerged thus far, keeping in mind that interviews are ongoing and that deep analysis of the data has yet to commence.


Facebook Instagram Snapchat
(most risky) (least risky)


Overwhelmingly, the most popular way in which alcohol experiences are shared online is through visual media. Still-capture photos were identified as the primary means of posting, sharing, and otherwise exposing people in one’s social network to alcohol-based activities. While it was acknowledged that this happens across a variety of different platforms, Snapchat and Instagram were highlighted as the two most frequently used social media platforms for sharing alcohol-related experiences online. These standards relate to discourses connected to social risk, social acceptability, and internet culture. Notably, people’s comfort in sharing alcohol-based information varies based on their perceptions of risk, which seem to fall on a spectrum of Facebook (most risky) > Instagram > Snapchat (least risky).

This risk management seems to revolve around the user’s own self-monitoring, as they seek benefits from sharing ‘fun’ information with their social network, while keeping in mind the potential consequences that could emerge if that same network disapproves of that shared information. By posting acceptable information, participants have described these positives results in terms of social capital. Direct positives on many of these platforms include receiving friend requests and gaining followers, and real-life positives discussed were linked to a person’s increased popularity online. On the other hand, by posting material that is seen as taboo by the online community, users expect to receive negative feedback and possible scrutiny by friends and acquaintances alike. These standards seem to be determined by the online cultures that exist for each platform, and each of these were described as unique social environments. How each person describes their standards and protocol is unique, but below is a rundown of each photo we use and some of the themes that have emerged so far. Continue reading

Stories have weight

Stories have weight

The past two years have been exciting for our team at the Center. Our first project interviewing Black youth about stigma and tobacco use has been eye opening, and we’re spending most of our time now coding interview transcripts and conducting analyses. We’ll be posting more on that in the future. We’ve also started a new project on Intoxication and Gender (Geoffrey Hunt is the Principal Investigator on that one) which will be included on the website soon. And, we are cautiously optimistic about the potential funding for two additional projects coming on board in the next few months. It’s been busy but so rewarding.

Because of all of these new projects, we’ve spent a lot of time thinking about ways to disseminate our research—that is after all an important part of our projects. But, questions have come up over the course of the past two years that we take with us as we start up new projects and develop new approaches to dissemination.

One issue in particular, that we’ve been thinking a lot about recently, is how to be both transparent in our research process (e.g., by sharing anonymized fieldnotes from our researchers, audio segments from interviews) while also not misleading the public about the results of our research. How do you showcase an interviewee’s perspectives in a way that both validates her lived experience but doesn’t lend more weight to her experience compared to others who participate in the project? We’ve rightly received criticism about this exact question in reviews of our grant applications and responded by talking about disclaimers and such that we can put up on the website.

But I’m not sure that’s sufficient. It’s funny because over the course of my career I have heard qualitative researchers talk about how we have to struggle to highlight the results of our work within a society that values numbers. But in our experience so far with dissemination, people’s stories have weight. I have never liked to talk about qualitative data as “stories”—it feels like it invalidates qualitative data as scientific knowledge. But interestingly in this context of online dissemination, when we have shared segments of our participants’ “stories”, they have reach and, perhaps one day as our social media network expands, they will have power.

Our goal is explicitly to highlight participants’ voices so that their perspectives about issues relevant to public health are highlighted. But what if one participant’s voice is heard above all others, and yet doesn’t represent the experiences of the group? As a qualitative researcher, I believe that a single experience is important. But what if a single person is an extreme outlier—the perspective may be interesting, but what if that extreme outlier is interpreted in such a way that it is presumed by the public to be representative? What do we do with that? Continue reading

Getting to a place of stability

Getting to a place of stability

Tower of Jenga blocks

CC BY-SA Guma89

This respondent was a foster youth who recently transitioned to independent status in terms of the state. She had been on the streets in the past, but she currently lives with her girlfriend and attends a vocational program to be a chef.

She said she smokes to relieve stress. “The City is losing manners… value and dignity,” she feels, and she said there isn’t much respect anymore. She smokes when feeling disrespected, and got a cannabis card to keep from “spazzing out” from work stressors.

She gave up drinking recently, but is surrounded by people who still imbibe and says she experiences pressure to go out socially where she may be tempted to drink. When she drinks, she smokes more. She said she’s not ready to quit smoking yet, but she is monitoring her smoking. She also enjoys vaping, but says vaping is, “kinda like halfways…not as fulfilling as a whole cigarette.” She noted trends that at first vaping was supposed to be better for you, but that now it seems e-cigarettes are not as good for you.

For single Black mothers and young Black men, she believes, it can take a long time to get to a place of stability (financially, emotionally and with family) to feel able to quit. By the time one gets to that place, generally one has children already, and they’ll have seen what you’re doing and be emulating it.  Of kids, she noted: “You see it, you do it.”

Critical public health research discussion list

We’ve started a new discussion list focused on critical public health research. We would like this list to be a place where researchers can talk informally about ideas and methods, and exchange helpful tips and advice. If you’re a researcher or student who is interested in critical perspectives on public health, please enter your email address below to sign up.

If you have any questions, please feel free to comment below or email us at We would love to hear your thoughts.


Digital media & critical public health

A grad student at UC Berkeley’s School of Public Health, Sharon O’Hara, interviewed our center director Tamar Antin about digital innovation and public health. Sharon then put together the great video below using iMovie.

Pretty interesting to see the combination of paths to exploring digital media engagement with public health topics here: both through the discussion in the video of the center’s work, and through the interviewer’s hands-on engagement with creating her own digital media artifact.

Social Media Interview with Tamar Antin from S O’Hara on Vimeo.



E-Cigarette (CC BY-SA Izuan Izam)

E-Cigarette (CC BY-SA Izuan Izam)

There’s a lot of discussion today about e-cigarettes. Will they help current smokers quit smoking? Will they jeopardize public health efforts that aim to make cigarette smoking socially unacceptable, or could their popularity further denormalize cigarette smoking? Will they be a gateway into cigarette smoking for young people? If e-cigarettes are less harmful than conventional cigarettes, does stigmatizing e-cigarettes threaten public health efforts?

Our current California Smoking Study, which focuses on cigarette smoking and the ways in which smoking stigma may have variable impacts on different communities, suggests that there is a need for additional research into the social and cultural meanings of e-cigarettes specifically, so that we can begin to understand their “promise or peril”. Continue reading

“Hey, y’all got to understand – y’all prolly scared of us… we scared of y’all too!”

“Hey, y’all got to understand – y’all prolly scared of us… we scared of y’all too!”


Drawing by focus group participant

[UPDATE: This post was reblogged at Ethnography Matters]

Street-level recruiting, downtown Oakland, Broadway 13th to 16th, Oscar Grant Plaza (formerly but officially known as Frank Ogawa Plaza). We’ve been talking to all kinds of people – students, workers, merchants, customers, pimps, players, hustlers, dealers, addicts, sex workers and eyeballing the BART police roust a youth for nothing that I saw. I’m standing in clouds of cannabis smoke exhaled from the people we’re talking to, and no longer feel how cold my head is. We’ve finally got our posse of people walking back to the office, and I’m struck by how secure one feels in a mass of people traditionally feared. People walking in the opposite direction make a wide berth around us, and some look at me disapprovingly, and I wonder about what microaggressions these young men deal with as they move through their lives. And then the hardest and loudest of the bunch paces Rachelle and I talking strategy.

“Hey, y’all got to understand – y’all prolly scared of us… we scared of y’all too!”

There’s a smile, but it’s pointed, and I know they are checking my reaction. I smile at him as if to say, “I hear you,” but then gesture to my colleague known for being even more quiet than I am, saying with a chuckle, “You know, I’m not sure she and I can take all six of you in a head to head.”

Drawing by focus group participant

Drawing by focus group participant

Brother with the neck tattoo has been inside before. Jail. I know it without knowing it. We’re on the tail end of the three quarter mile walk back from street-level recruiting. One of the little hoppers (young hustlers) has already very pointedly asked if we’re FBI or with any kind of police. “Where? That building that got FBI in it?” He might as well not ask – my reassurances that they will leave our company unmolested are met with a tough-generous smirk and posture that lets me know he thinks the whole thing smells no matter what I say, but the steady footfalls and banter of the bigger, older muscle along with the joint being passed back and forth between them placates them enough for me to drawl, “They gone. They moved out of the building.”


“Dunno, and don’t want to. Ugh. We don’t get off into all that. Don’t nobody want to talk to the police more than they have to.”

Their thoughtful silent assent keeps us walking.  Continue reading

Another ‘ugly truth’ ad

Another ‘ugly truth’ ad

One of our first interview respondents, Jovante*, a 19-year-old African American artist, mentioned this ad from the ugly truth campaign (“the nation’s largest smoking prevention campaign for youth and young adults“):

For Jovante, this ad was suspicious. He thought it was over the top, did not make sense, and that it suggested ulterior motives on the part of the people behind it. Although the ad’s explicit message is anti-smoking, Jovante felt that its effect on some young people might be “the exact opposite,” especially in light of his broader sense of membership in a group that has been exploited and marginalized:

“They would rather we smoke tobacco and kill ourselves, because they get money from it.”

So then today I came across another ad from the ugly truth campaign. Unlike the ‘cat pee’ ad, I’d never seen this one before:

“This is from Big Tobacco’s files. It’s a plan to sell cigarettes to gays and homeless people, and they called it ‘Project Scum’… And the ones on the left are just some of the ways Big Tobacco labeled African Americans.”

I wondered what Jovante would think of it. Seems like he would find it more credible.

Scanning this working paper by Deborah Lupton (thanks Tamar!) on the use of disgust in public health campaigns, I’m struck by how the first ad plays to 3 out of 4 kinds of disgust described in the paper… There’s “animal reminder disgust”, “matter out of place disgust” and “liminality disgust”, all in one super disgusting ad.

The fourth disgust-egory is “moral disgust,” and maybe that’s what the second ad appeals to. But unlike the examples in the paper, it’s not moral disgust aimed at people who use cigarettes. Instead, the target is marketing tactics.

Big difference in how these two different kinds of messages may affect people who are already dealing with stigma and marginalization in other parts of their lives.

*’Jovante’ is a pseudonym

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