ABSTRACT
This chapter presents the formation of global public health rationales through problem definitions surrounding alcohol, illicit drugs and tobacco use. It discusses how this has involved certain constructs of the problems’ nature and certain ways of addressing them. The first part of the chapter contains historical accounts of the rise of the three policy areas on the global health agenda. The second part discusses concepts, worldviews and epistemologies as gathering and mainstreaming forces in contemporary times. What unfolds is a peculiar inclusive yet exclusive agenda. On the one hand, the problems have lately been increasingly conceptualised together as stemming from the same kind of disorders and circumstances. On the other hand, the conceptualisations of public health from the perspective of dealing with alcohol, drugs and tobacco are highly dominated by synchronised psy, medical and biological disciplines, which are epistemically laundered, exclusive and homogeneous. The chapter shows how the idea and rubric of dependency has been crucial for seeing a common aetiology. The worldview of this epistemic global public health framing is one where regional and cultural variations are rather disregarded, the geographical variations emphasised being mostly the ones between high- and low-income countries. Another important aspect of the global polity in these areas is that of the shared enemies of global commercial and criminal actors.
