Being powerful is like being a lady.

If you have to tell someone you are, you aren’t.

                     – Margaret Thatcher

Throughout our lives, we will all experience changes to our environment that we don’t care for.  What can you do about it?  Broadly speaking, there are three possible responses that you might have.  Political scientists have termed them Exit, Voice or Loyalty.

Consider the situation in which the state introduces a new policy – say, a budget cut – that clearly hurts some of its citizens – say, the 22 percent.  How should we react?  Although we wouldn’t like this change, others would definitely see it as an improvement.  Our response choice depends on what we expect to happen as a result.

Exit is the term used to describe what we do when we accept the deleterious change in our environment, and simply alter our behavior to achieve the best possible outcome under the new conditions.

We use our Voice when we complain, protest, or otherwise take direct action aimed at changing the environment back to its original condition.

Loyalty is when we accept the new policy, and make no change to our behaviors.

Our choices become more complex when we consider that the state also has choices, and that we can’t easily anticipate what the state’s response would be if we select Exit, Voice or Loyalty.

Turning Exit, Voice and Loyalty into… Payoffs.

Political scientists use game theory to understand the balance of power between the state and its citizens.  In the EVL game, there are two important observations that have direct relevance to us.

First, the state will be willing to respond positively to a citizen only when a) the citizen has a credible exit threat, and b) the state is dependent on the citizen.  The state has a compelling reason to respond to our voice only when both of these conditions are met.  Without them, it’s the flip of a coin.

Second, no matter how dependent the state is on the citizen, in the absence of a credible exit threat, the citizen is a sitting duck.  Because changes that are harmful to our patients are by definition beneficial to someone else, the state can be expected to eventually make harmful change.

In our case, terms like credible exit threat and dependent are, of course, used metaphorically.  But there ARE things we can do to improve our political payoffs.

What is the nature of our credible exit threat?

In what ways is the state dependent on us?

When we fully understand the answers to these questions, we will understand the keys to occupying tobacco control.

Let’s talk about this.  What do you think?


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