Etiquette and Contagious Diseases

They are kind of cute! — “Why don’t the contagious among us stay home or wear those cute little paper nose and mouth covers or at least feel bad about putting the rest of us at risk of sharing their misery? More people died in the post-World War I influenza epidemic than died in the war. Garden variety flu germs can be life-threatening to the elderly or those with vulnerable respiratory systems.”
— Photo, Etiquipedia’s private library

In 1998, the State of California banned indoor smoking in many public places, much to the delight of non-smokers and those suffering from respiratory problems. A law professor from UC Berkley wrote the following article, which appeared in the Los Angeles Times. The importance of respiratory etiquette that the professor outlined is timely, considering the world continues to deal with Covid-19 and our normal “cold and flu season” is nearly upon us.

Thank You for Not Sneezing

California’s assault on secondhand smoke reached its historic high this New Year’s, when even indoor areas in bars and casinos became smoke-free by force of law. The rules on smoke exposure have taken a 180-degree turn in less than a generation. In the United States of my youth, every citizen was hostage to other people’s cigarettes in airplanes, in offices and in almost every other public space. Now the indoor areas of public life are all nonsmoking zones— an inconvenience for the 25% of adults who smoke, but a benefit of large proportions to the respiratory systems of the 75% who do not.

But even smoke-free California is not a safe place to take your lungs to the office, on a bus or anywhere else in public. In this the season of cold and flu, the greatest hazard of appearing in public is not tobacco smoke, but rather contagious disease. And strangers who would not dream of blowing smoke in your face seem happy enough about coughing and sneezing whenever they see you coming.

Isn’t there a double standard here, when the same folks prohibited from smoking in my office building can sneeze me home for a week of hell with the reigning bacterium of the season? Why don’t the contagious among us stay home or wear those cute little paper nose and mouth covers or at least feel bad about putting the rest of us at risk of sharing their misery?

Could it be that the analogy between secondhand smoke and free-flying germs is farfetched because tobacco is deadly while colds are merely inconvenient? Nonsense. More people died in the post-World War I influenza epidemic than died in the war. Garden variety flu germs can be life-threatening to the elderly or those with vulnerable respiratory systems, a much quicker and much clearer threat than the statistical associations and 30-year time lags that constitute the case against environmental tobacco smoke. And anyone who thinks that this year’s killer colds are merely inconvenient does not have one. The only larger harm a stranger can inflict requires a deadly weapon.

Is the difference between environmental smoke and environmental germs the fact that there is no way to protect against disease contagion that is as simple as not smoking? But what if sick people stay home or cover their mouths? I am sure it is a burden to take such precautions, but isn’t the whole point of our smoking restrictions to impose the inconvenience on those who would otherwise cause harm?

Perhaps the difference is that potential victims can defend themselves more easily from public germs than from secondhand smoke. There are, after all, flu shots to be had every fall. But not all flu bugs respond to the shots available. And if anybody ever finds a vaccine that protects against colds, the financial rewards will make Bill Gates seem middle class. The only way to avoid the urban germ highway is to live alone and stay home all winter.

I’m not advocating passing a law that requires germ-free public spaces. But two smaller lessons do come from the contrasting treatment of germs and cigarettes. The first lesson is that what we tolerate in public is much more a matter of particular social expectation than scientific studies. The French read scientific journals just as assiduously as do Americans, yet the average French café contains more smoke than a forest fire. You are more likely to encounter a face full of tobacco smoke if you go to Japan this year than you would in Los Angeles. But you will also notice hundreds of people on the subway in Japan who wear paper masks to avoid spreading contagious disease that they carry. Which culture is more considerate depends on the particular subject of the inquiry. The standard for what is polite in public varies tremendously from one social setting to another.

Now for the optimistic lesson. If the social customs concerning secondhand smoke can change over time, maybe there is hope for some controls on germs as well. What we need is not a law, but an etiquette of contagious disease. Perhaps the near future can bring us to a standard where we expect more effort from ourselves and one another to avoid multiplying the bacterial miseries of our winters. — Franklin E. Zimring, U.C. Berkley, 1998

Etiquette Enthusiast, Maura J Graber, is the Site Editor for the Etiquipedia© Etiquette Encyclopedia