Pharmaceuticalisation in the city

Conceptualising the present study

Project fieldwork was conducted over a two to three week period with each of 55 households sampled from four major New Zealand cities. Households were purposively selected to include a variety of household compositions and ethnicities and to provide sites where medication use was frequent, important and involving other household members. We developed a multi-method approach to data collection, which involved household group discussions and individual interviews, alongside diary- and photo-elicitation projects where householders were asked to picture medications within their homes and the broader cityscape. For this paper, we extracted all data from this larger corpus that documented instances where medications were discussed which arose from participants’ excursions across the city and through their engagements with media forms.

Participants went out into the city and located, observed and documented medications and related promotional materials within specific urban settings with a view to discussing these in subsequent interviews. The meanings attached to their observations in interviews moved beyond the frame of particular scenes depicted to situate these within broader issues of pharmaceuticalisation. In a sense, we asked our participants to become urban commentators, to transit the city, observe the emplacement of medications, and recount what they observed through their photographs, diaries and interviews. By traversing and documenting aspects of their urban environments these participants wove different locales into the pharmaceuticalised cityscape.

In bringing some coherence to these journeys across the city and empirical materials produced by our participants, we embrace and extend the metaphoric figure of the flâneur who transits the city and interprets local events from a critical distance (Benjamin, 1969). This iconic figure in urban scholarship (Benjamin, 1969; Short, 2014) aids us in considering the mundanity of where medications are typically located, passed by, looked at, pondered, touched, purchased and consumed within the city. For us, the flâneur invokes more than a detached stroller who takes voyeuristic pleasure in witnessing situations and events (Weinstein and Weinstein, 1991). Our flâneur strolls to know, to record and to understand the city. As Benjamin (1969: 41–42) notes, the flâneur is like the detective, ‘… for behind his [sic] indolence there is the watchfulness of an observer who does not take his eyes off a miscreant … He develops forms of reaction that are in keeping with the pace of a big city’. In transiting the city, our flâneur, like Benjamin’s (1969: 36), ‘… goes botanizing on the asphalt …’ with ‘… penetrating eyes …’. This metaphoric figure helps us refract some of the dynamism of contemporary urban life and how people moving through the city are exposed to, accept, ignore, foreground, disrupt and re-interpret the place of medications in the cityscape and the pharmaceuticalisation of the city.

Correspondingly, our analysis draws on the device of the flâneur to construct insights from strollers across the four cities in which this research was conducted. We are not arguing that our participants became flâneurs, but rather that they adopt a mobile analytic gaze of flânerie (Short, 2014) when tasked with picturing and reflecting on the presence and meaning of medications in the city. The analytic device of the flâneur offers us a means to interpret the rhythms and commonalities of the pharmaceuticalised cityscape through the eyes of inhabitants participating in this research. In doing so, we do not seek to deny the heterogeneity of experiences anchored in class, ableism or ethnicity; our focus here is on the general everyday experiences through which the city is pharmaceuticalised. This orientates us away from differences in the experiences of individuals towards broader, shared and emplaced ways of engaging with medications and the city (Parker, 2015; Spinney et al., 2015).

In recounting the significance of urban settings and the medications located within them, our strollers invoke a nexus of meanings and practices that exceed the materiality of any specific place or object (Stolte and Hodgetts, 2015). Guiding our analytic processes is Heidegger’s (1927[1973]) concept of the totality of involvements or network of meanings and relationships anchored in particular spaces and things. This orientation to people and things in the city recognises that a particular urban involvement, such as reading an advertisement for a medication in a shop window, is caught up in a network of meanings. Such mundane events are part of a network of shared understandings of things and their functions, which we regard as central to the pharmaceuticalisation of the city. Everyday urban life requires inhabitants to traverse these spaces of involvement that take form across particular streets, supermarket aisles, pharmacy shelves, domestic settings and media texts. Correspondingly, our analysis documents ways in which our participants’ considerations of medications within urban locales can inform our understandings of the pharmaceuticalisation of the cityscape. A key consideration is how general structures and relationships (totality of involvements) are reproduced through particular (personal) situations and encounters; we look locally in order to understand the broader processes of pharmaceuticalisation of the city, in line with the seminal urban scholarship of Benjamin (1969) and Simmel (1903[1971]).

The analysis was initiated by examining the data from the entire project corpus and identifying all material relating to medications as emplaced in the cityscape. This amounted to more than 100 pages of textual material and more than 150 associated images. This material was read and discussed within the research team, to develop iteratively and collaboratively a set of analytic categories and interpretations, structured by the research intent to examine the pharmaceuticalising spaces of the city as seen through the device of the flâneur. The analysis is presented below in three interconnected sections. The first explores urban thoroughfares where people encounter promotional materials that invoke various medicinal substances. The second focuses more intimately on core commercial sites, such as supermarkets, pharmacies and petrol stations, where medications are located and accessed. In the third section, we follow our strollers into the domestic sphere where they encounter further mediated depictions of medications across television, radio, print and online forms.

Strolling through the cityscape

Texts advertising medications permeate shop windows and mall thoroughfares as constant reminders of how good health can be achieved for a price. In considering such emplaced objects, we have clustered participants’ photographs of the presence of medications into three broad categories: thoroughfares, non-prescription sites and prescription sites. The flâneur literally transits through a medicinal marketplace pointing out various features associated with access to particular medicinal products. Depicted is a cityscape that affords products for enhancing the lifestyles and health of inhabitants.

Heading out for the day, one participant is drawn to notice cute animated characters seeking eye contact from an advertisement for Inner Health Plus (Figure 1, top left). This advertisement is designed to rupture the blasé attitude of passers-by (Simmel, 1903[1971]) and ‘whisper’ to the flâneur about health maintenance and enhancement (Benjamin, 1969). The Martian characters provide a euphemistic way to consider private bowel issues in a public space. The Inner Health text asserts that this product is necessary to ensure ‘the maintenance of a normal healthy gastrointestinal system and digestive function’. It reminds readers of potential ‘inadequacies’ in terms of having ‘unhealthy’ and un-optimised digestive systems. Below, Trish (36, Administrator) emplaces this text and medicinal product:

They just had this huge shop front window with Inner Health Plus … Those little Martian men … It’s a tablet – my boss has actually got some at work in the fridge – and they’re saying it just sort of keeps your insides all healthy … If you’ve had antibiotics and things like that kill your good bugs … Inner Health Plus they say take one and you keep your insides healthy.

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Figure 1.

Medicated thoroughfares, micro spaces and public displays.

Such advertisements are recognised as mundane features of the city that promote an idealised ‘pharmaceutical self’ (Jenkins, 2010) that personifies health, happiness and energy. Our flâneurs’ reactions to such advertisements reflect their immersion within a social imagination that routinises the use of such medications. The promotion of the healthy active self is also evident in the top right frame of Figure 1 depicting an advertisement for another enhancement product ‘Rev it up’, which was associated with the maintenance of an energised lifestyle. Non-human urban actants such as these advertisements are designed to generate reactive agency on the part of passers-by (Busfield, 2010). Our strollers recognise the promotion of a link between these medicinal products and a healthy and re-energised self. A clean and active lifestyle is simply another purchase away in the commodified city. The advertisers are taking advantage of busy lifestyles to sell the idea that urban dwellers can pack 36 hours into 24 hours by consuming this substance. In the process, societal issues around the hectic nature of life in the consumer city are disguised as health problems and medications are offered as a remedy. Such advertisements are ‘cultural products that have been “fabulated” by advertising creatures, that can then be used by people to fabulate and make sense of the world’ (Cronin, 2010: 111). To fabulate is to engage in collective storymaking that gives hope and allows people to engage with and manage life’s dilemmas and difficulties.

With reference to particular advertisements and commercial spaces Maddy (34, Home-maker) pictures a pharmaceuticalised city inhabited by various substances. Supermarkets, petrol stations and convenience stores (Figure 1) comprise prominent locales for the promotion, obtaining and routinising of non-prescription medication use. In relation to the left-hand frame (Figure 1, row 2), she notes:

I was trying to take photos of supermarkets … I just took a photo of the front of the building … You can get everything there. Well you can’t get like antibiotics and stuff like that. But you can get natural stuff like anti-inflammatories, vitamins, all that sort of stuff. You can get cough syrup. You can get throat lozenges, Panadol, Nurofen. You can get like that Nurofen Plus, and Panadol Rapid. All of that sort of stuff, which is fairly hefty doses … I mean, can’t you make ‘P’ [methamphetamine] out of cough syrup?

Convenience of access is associated with the routinising, normalising and naturalising of the consumption of medications as ordinary features of urban life. This is reflected in the ‘snapping’ of a supermarket sign and reference to being able to get ‘everything’ at the supermarket, which construct medicinal products as simply yet another grocery item. Likewise, the central frame depicts a petrol station as another convenient site for accessing ‘cures’ for mundane ailments such as sore throats and hangovers:

There’s gas stations [Figure 1, row 2, right], now have little packets of things, don’t they? Little packets of Strepsils … At least if you’ve got a sore throat you can have a Strepsil or little packets of Panadol or whatever they’ve got … That’s convenient, isn’t it? … Probably dairies (convenience stores) [Figure 1, row 3, left] stock a few more things now, too, don’t they. (Rosie, 42, Home-maker)

Medicinal commodities are positioned alongside products such as confectionary and tobacco:

You can get lollies [confectionary], groceries, all that sort of stuff there. You can still get medicines there … Yeah because like, well I don’t know if even my eldest son would be able to buy Panadol at the dairy. Yeah, I don’t know if they’d let a little kid but I don’t know they can’t buy … cigarettes. But they can go buy Panadol? Awesome [sarcastic]. (Maddy, 34, Home-maker)

Medications are positioned here as another product to be accessed at one’s convenience. An issue implicit in the above extract is concern over the ready availability of these substances to children. Such sites of medicinal convenience are juxtaposed with other micro-spaces in which one can access controlled or prescription-only substances that address more serious health concerns that require medical consultation. Figure 1 depicts the external displays, entranceways and signs for a pharmacy and a medical clinic. Although these later micro-spaces are positioned as central to the formal medical system, there is a familiarity with these sites as medicinal locales that: ‘… represent relief to my problem’ (Hazel, 41, Contractor).

To recap, medications are presented as little friends that can be relied upon to keep the consumer-citizen healthier and happier. Inner Health Plus and ‘Rev It Up’ advertisements epitomise the production of needs that require gratification through constant purchases (Bauman, 2007). To have a healthy gut and energised life, citizen-consumers are compelled to exercise moral responsibility for themselves by purchasing such readily available products. The focus on an enhanced happy and healthy life in such promotional products is designed to encourage perpetual consumption. One needs to keep consuming such products in the hope of achieving health-enhancing ends. In this way, consumer ‘needs’ become compulsions or urges that, whether taken up in the encounter or not, offer a new lease on life and the potential for a new you (Bauman, 2007).

Strolling inside key sites of pharmaceuticalisation

Moving through the urban environment, we witness a cityscape re-imagined through advertisements and actual medications. Entering particular locales, our stroller encounters medicinal displays on counters and shelves, along with various other products. Below, we venture into three key commodified spaces: the convenience store as a routine site for obtaining non-prescription medications; the supermarket where a greater abundance of substances are readily available; the hyper-pharmaceuticalised space of the contemporary pharmacy where prescription and non-prescription substances abound. This section extends our consideration of the promotion of ‘citizen-consumers’ (Will and Weiner, 2015) who manage their health, lifestyle and self, in part, through involvements with medications.

Figure 2 (row 1) depicts non-prescription substances inside the convenience store where substances for managing mundane ailments reside. In relation to the left frame, Otile (22, Student) notes:

The first photograph I took was in a dairy and it’s of a Strepsils, Vapodrop thing that you can take if you’ve got a sore throat … It was at the counter where you go to pay … The rest is all, like, lollies and chewing gum. They put it there so people can be aware of it that it’s there in a dairy … This next photo is of …‘Habitrol’ [Figure 2, row 1, right]. It helps you stop smoking. It’s gum … I think this is the first time I’ve noticed that there were products like these in front. It stood out to me because it’s in that box that reminds me of Panadol [paracetamol]. It’s really serious – the packaging. Like, if you look at it, it doesn’t look fun like anything else that would be in a dairy … And I automatically think it’s something to do with medication … And it’s expensive.

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Figure 2.

Inside convenience stores, supermarkets and pharmacies.

In the store medicinal products (Strepsils) are positioned alongside non-medicinal products (sweets) as mundane objects to be purchased when the need arises. The prominent emplacement of Strepsils by the cash register is recognised here as important for reminding customers of the availability of these substances and for prompting ‘spontaneous’ purchases. The convenience store is also presented as a site for obtaining medicinal products to help one overcome dependency on harmful products, such as cigarettes, that are also for sale. Reference to noticing Habitrol is important because this consumer-citizen reveals a familiarity with a taken-for-granted visual grammar for recognising certain products as medicinal. We can see how conventions for packaging medicinal products, such as Panadol, work as intertextual anchor points for recognising other products, such as Habitrol, as being medicinal. We also see intertextual comparisons between cheaper products for less serious ailments (sore throat) and more expensive products (Habitrol) for responding to tobacco addiction.

Although stocking various medicinal products, the convenience store represents a lesser site for pharmaceuticalisation than the supermarket, where more products are available. The health section of the supermarket (Figure 2, row 2) exemplifies pharmaceuticalisation on a substantial scale, where medications are allocated considerable shelf space in their own right:

The thing is the amount of medication that’s available … That’s at least half of one side of an aisle is just medications [left]. Can you see the yellow tabs? All the specials, so even the medication is on special … Then that’s just looking further down from the other side. All these sections of different medications. (Bryce, 62, Consultant)

This quote reflects how pharmaceuticals have been constructed as ‘normal’ commodities, to the point that shoppers look for bargains and notice when medications are on special offer. Also important in considering the promotion of medications as common consumer goods is how pain medications are given pride of place in the supermarket:

What I didn’t notice at the time was the different types of Panadol there are. And straight underneath that you’ve got Nurofen as well and up the top you even got a Pams’ [generic/house brand] product of Ibuprofen – probably a type of Panadol and just the different types of tablets you can get now … But very surprised to see that Pams are even making medication and it kind of worries me … But if I was to go to the supermarket looking for something I think I’d stick with something that I’d used before that works rather than a cheaper brand when it comes to medication … I see Pams as a large company and I think I’d go for something more specialised in the particular product or medicine. Whereas Pams makes food and all types of things and I think medication’s different. (Peni, 29, Policeman)

In the supermarket non-prescription medications can be purchased along with one’s ‘other groceries’, rendering the acquisition of medicinal products as a normal part of a shopping excursion. Shoppers have gained considerable understanding of pain medication brands and voice associations between brand, cost and quality, despite different branded products having similar chemical compositions.

Marketing plays a role in the increased normalisation of medications as grocery items and mundane consumer choices in terms of alleviating symptoms such as pain. For example, Figure 2 (row 3, left) presents an advertisement that uses positive emotions as a sign of health:

This one here they had a photo of this lady smiling …, which was quite funny because, like, you see her then you see medicines then it’s like you actually have a correlation with being healthy and being good and feeling happy. (Paul, 26, Student)

Depictions of people prior to consuming a particular product often present them in pain and unhappy. In contrast after taking the marketed product the same consumer is presented as pain free and happy. These advertisements tell shoppers that they do not have to be in pain or sad if they just purchase and take the substance on offer. They can feel happy and perhaps better than before (Gabe et al., 2015b).

The pharmacy, in contrast to the supermarket, comprises a specialised consumer space stocking the widest range of prescription and non-prescription medications. Figure 2 (row 3, right) shows a pastiche of prescription and non-prescription substances. In the foreground, the display of colourful packaged non-prescription medications contrasts with the clinical, matter-of-fact brown bottles and white boxes of the restricted and serious space of the dispensary. As Bryce (62, Consultant) notes:

That’s the prescription section [background] … There’s a whole lot of medication there that you haven’t direct access to whereas all the others [foreground] we saw were … things that you could just go and buy off the shelf. If you think it’s good for you, you can just go and buy it.

This image and extract reveal how non-prescription and prescription medications are situated within specific domains within the pharmacy space; the counter offers non-prescription medications, whereas the area behind the counter offers prescription medications, which only pharmacists can access.

Figure 2 (row 4, left) depicts how advertisements are also evident in the pharmacy space alongside the products, invoking reflections on the link between such objects and consumer demand for particular products:

It made me feel like there’s information available to patients whether or not their doctors like it they can go back and say, ‘I saw an advertisement for this product, is that different to what I’m on because this thing I’m on I don’t like?’… I’m a bit sceptical about that sometimes. But I felt like it gave people a bit of choice and maybe a heads up to what’s in the market and maybe an opportunity to discuss it … It’s osteoporosis but they’ve got older woman so obviously marketing it well, but maybe a bit of empowerment for the consumer. (Hazel, 41, Contractor)

This quote invokes how advertisements infiltrate medical consultations and decision-making. It raises the issue of consumer demand being cultivated through the promotion of particular prescription medications (Busfield, 2010; Williams et al., 2011). We see how the pharmacy and medical clinic have been infiltrated commercially by advertisers to influence consumer choices (Cronin, 2010). Such intertextual links span out to a raft of urban spaces. The pharmacy space is textured by both medicinal products and promotional materials that can invoke consumer memories forged in urban space such as the home. This is evidenced when our stroller discusses his photo taken in the pharmacy and invokes a television advertisement for the same product that had been viewed at home:

Called ‘Celebrity Slim’ [Figure 2, row 4, right] and I recognised this product because of the ad on TV… And it had this really large lady and it showed again a picture of her when she was a bit smaller. I thought to take this photo because this was one of the many dietary plans in the chemist that I saw … I think it’s sachets because, look, you’ve got the colours and I think the flavours. Yeah, berry, coffee latte … Instead of eating you replace your meals. Like, it’s like trying to get you hooked on these rather than food. (Otile, 22, Student)

Here an advertisement is used as an intertextual anchoring point to read a medicinal object within the pharmacy space. Our stroller takes us verbally out beyond the frame of a photograph from within the pharmacy to situate what is depicted across urban locales, and in doing so, raises broader issues around the promotion of dietary products to women. In the process, the totality of involvements (Heidegger, 1927[1973]) around the commodification of medications and pharmaceuticalisation become more evident.

Through the practices and commentaries presented in this section, we can see the intersection of neoliberal notions of self-control, choice and consumption as key elements for responsible consumer-citizenship (Gabe et al., 2015a; Jenkins, 2010). Selecting, commenting on, or rejecting certain medicinal substances gives our strollers a sense of control and agency within the commodified cityscape. We witness the manifestation of broader relations in society through particular medications that can bind urban inhabitants within the present socio-economic order (cf. Heidegger, 1927[1973]). We take these issues further in the next section through a consideration of domestic space.

Strolling through domestic and online spaces

Engagements in flânerie across the cityscape do not end when our participants go home and close the door. Various broadcast, print and social media forms offer further public spaces of pharmaceuticalisation that coalesce within domestic dwellings (Williams et al., 2011). At home with our strollers we see the double articulation of space (Hodgetts et al., 2010) where participants are physically located domestically whilst engaging with medicinal materials via media spaces. This domestic media nexus offers consideration of multiple medicinal products that are received positively, questioned, and woven by inhabitants into the fabric of their everyday lives (Hodgetts et al., 2011). Reflecting on a particular evening, Rosie (42, Home-maker) reports: ‘Watching TV, noticed “Health Care Diary”, Men’s Health, “Cialis”, “Dimetapp”… Get an email for “lemon detox” special … It’s just talked about so casually now’. The domestic sphere is a key site for pharmaceuticalisation where public and private realms are meshed through contemporary media consumption, involving mediated strolls (Parker, 2015).

Figure 3 depicts advertisements from within the domestic sphere. Hazel (41, Contractor) comments:

That’s [Figure 3, top] some kind of diet supplement that is supposed to make you lose weight … It’s total quackery … and dangerous … Especially if it’s marketed to women obviously … Who knows what’s in it? … I couldn’t imagine how you could lose weight like that … If it’s something that suppresses your appetite, well that’s not healthy.

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Figure 3.

Advertising in the domestic sphere.

Such accounts reflect critical engagements with the use of medications to regulate behaviour such as eating. Representations of such substances are contested within the domestic sphere through accounting practices that associate advertising with profit rather than health. Such cynicism extends to the use of techniques such as testimonials:

They always have glowing testimonials from people … I believe that anybody can write that kind of testimonial. So I would doubt the validity of it … And promoting medications as a way of life, I don’t approve of that. I think particularly in TV advertising they do that. It’s branding, you know, saying you need some of these otherwise you’re just not going to be living your life to the full. (Lisa, 60, Tour Guide)

This extract reflects the self-assertion of a critical consumer-citizen who does not ‘buy into’ the bigger message of pharmacy advertisements linking particular products with an optimised life. Several participants commented on the primary role of television in the promotion of everyday medicinal products.

Referring to another television advertisement (Figure 3, bottom) Peni (29, Policeman) also noted, ‘it was a telephone and it’s a Dettol ad and I thought it’s kind of a type of medication in that it kills bugs or it prevents illness’. The telephone handle is positioned as a site for the battle against germs that must be treated with particular substances to eradicate the threat to family health. Here we see signs of resistance to the pharmaceuticalisation of everyday objects and practices related to eating and cleaning.

The cynicism of these consumer-citizens extended to the continual marketing of medicinal products to meet manufactured deficits and is related to mundane domestic substances such as toothpaste as well as anti-depressant medications:

We’re continually marketed to and sold stuff from a deficit point of view – if you do this then your life will be better. A good example is the TV commercial for Sensodyne toothpaste for sensitive teeth. It gets marketed in a similar way as depression … Everything seems to get pitched as a condition for which presumably there is a cure. (Natasha, 48, Researcher)

Such urbanites recognise and question why they are constantly being told that they can feel better and be healthier and safer by consuming particular products. Also evident in such extracts is the way in which medications and associated messages and ideals become interwoven with efforts to consider, actively adopt, or question the sense of health being promoted across a range of products (Schlosser and Hoffer, 2012).

There appears to be considerable scepticism about promotional information, and that is combined with a pragmatic approach that accepts such information as part of the contemporary cityscape within which decisions about medications are made. The third person effect (Hodgetts et al., 2010) emerges in that one can accept one’s own competence to read advertisements critically as an active consumer, whilst also being concerned about the impacts of the same advertisements on uninformed others:

I kind of wonder where they’re getting all their information from cos I’m just thinking of my sister in Canada – she can go crazy reading health magazines … and then suddenly she’s taking like six supplements a day … Some of the things that are being advertised are simply for the worried well or for people that want an easy way out. You want to lose weight – eat less, exercise more. I know it’s a little bit more complicated than that but, really, you can’t keep on eating takeaway food and not exercising and then take one of these wonder pills and think … your life’s going to suddenly turn around and be wonderful. (Erica, 40, Research Advisor)

Cynicism about the promotion of medications can be read as an important element of pharmaceuticalisation in that it provides a sense of agency for ‘discerning consumers’ who differentiate themselves from uncritical purchasers. However, concerns about the impacts of advertising on uninformed consumers do not necessarily undermine processes of pharmaceuticalisation. Such challenges are contained through the reproduction of a dominant consumerist narrative around ‘informed choice’ on whether one consumes a product or not. The ‘right choices’ are made by diligent citizen-consumers who stroll on line to seek out the necessary information to inform themselves about particular products (Spinney et al., 2015). In doing so, they take ‘personal responsibility’ to scrutinise the properties of the substance and side effects using the internet and demonstrate their competence and social fitness in the process. The resulting information can then be brought into conversation with health professionals:

The other one is people … go to look up your condition on the internet … And you sort of look at the meds that they’re telling you to have and you wonder if I can just get that medication at the chemist without going to the doctor or, alternatively, you turn up to the doctor and go, ‘I think I’ve got this problem and I need this medication’. (Tane, 40, Computer Technician)

Mediated information regarding particular medicinal products is brought into doctor and patient interactions in other urban locales and woven in decision-making regarding health management. Pharmaceutical companies are aware of such practices and push their products through various media channels using techniques such as encouraging consumers to ‘ask your doctor about …’. Correspondingly, some people demand access to particular medications based on information gleaned from sources such as medicinal websites (Cloatre and Pickersgill, 2014; Will and Weiner, 2015).

‘Information’ from the internet can take on a life of its own in subsequent social and healthcare interactions, being discussed with doctors, friends and family across a range of urban locales. This is despite the fact that citizen-consumers are often unaware that many of the internet sources they consider to be independent are actually part of DTCI campaigns produced for pharmaceutical industries (Belisle-Pipon and Williams-Jones, 2015). Materials accessed via websites are often written by pharmaceutical companies, but are not obviously identifiable as such and so carry a veneer of impartiality. In promoting particular products, such websites seek to hide the commercial interests and exploit citizen-consumer information seeking and trust to influence ‘choices’. More broadly, ‘The website’s visual aspect thus reinforces in the viewer’s mind (1) the benefits of drug therapy in general over other options and (2) the sponsor’s drug, which is arguably the primary objective of this promotion campaign’ (Belisle-Pipon and Williams-Jones, 2015: 262).

To recap, a range of promotional materials enter domestic spaces of the city where promotional objects appear to play a constitutive role in urban lives, positing our urban commentators as health consumers. Effort is required on the part of our participants engaged in flânerie to be active seekers of information on particular products. Extracts explored above reveal how the networks of involvements (Heidegger, 1927[1973]) surrounding pharmaceuticalisation are not always intrinsically coherent and manifest contradictions through which the rhetoric of consumer ‘choice’ functions to repair potential hegemonic ruptures to pharmaceuticalisation.

Discussion

The pharmaceuticalisation of the city has received little scholarly attention in urban studies or public health. This article has explored how the contemporary New Zealand cityscape is textured with medications and related promotional objects. We have begun to consider how the emplacement of promotional materials and substances across specific micro-spaces constitutes urban pharmaceuticalisation. The contemporary cityscape exhibits a range of medicinal products, which often have positive implications for the prevention, management and curing various ailments (Greene and Podolksy, 2009). In the commodified city, ‘selling sickness’ and the promotion of medications can also have negative consequences (Busfield, 2010), including the transformation of various human capabilities and conditions into issues warranting pharmacological intervention (Abraham, 2010; Cloatre and Pickersgill, 2014; Williams et al., 2011).

Urban scholars have explored how human movement and interactions across various spaces is central to the production of the commodified city and associated subjectivities (Cresswell, 2013; Cronin, 2010; Parker, 2015; Short, 2014). This article contributes to scholarship in this area by taking readers on a preliminary stroll through the city to explore how, as material and symbolic objects, medications are woven into contemporary city life in New Zealand. We have documented how pharmaceutical companies promote medications to associate their products with enhanced, healthy and happy lifestyles. Promotional materials hail citizen-consumers, offering control over their health, mood and bodily functions (Jenkins, 2010; Will and Weiner, 2015). Consumer-citizens are offered a chance to be healthier, happier and better by simply consuming particular substances. Their encounters with emplaced medicinal objects open up new and prescribed possibilities for an enhanced life (Bauman, 2007), the resolution of an ailment and the prevention of illness. Urbanites do not even have to purchase or consume a particular product to become hailed into being by it. Consumer-citizens just have to encounter these objects to become re-embroiled within patterns of involvement that reproduce the commodified city (Heidegger, 1927[1973]). Movements through and engagements within particular pharmaceuticalised locales resituate inhabitants within a moral universe of health consumption. Further, in reported encounters with promotional materials explored in this article, we can see the liquefying of the Cartesian subject/object distinction (Bauman, 2007), whereby through encounters with medicinal products urbanites purchase the subjectivity of the healthy, medicated consumer-citizen (Jenkins, 2010; Will and Weiner, 2015). Briefly, through their encounters with medications within and across various locales, consumer-citizens become interpolated agents of the pharmaceuticalised cityscape that is constituted through a network of spatialised relations between people and medicinal products.

Simmel (1903[1971]) observed that cities produce new types of social relations and constitute spaces within which people can detach from the overwhelming stimulation of intense urban settings by retreating into a blasé attitude. Cities often demand such detachment. By going out to picture the world of medications our participants extend their gaze outwards again, focusing on the taken-for-granted aspects of their immediate surroundings as flâneurs. The figure of the flâneur proved useful for bringing coherence to urbanite encounters with medications across the various locales considered. In extending the typical public range of the flâneur, we followed participating flâneurs from thoroughfares and key commercial spaces, into the domestic realm, and then into the media realm. Engaging in flânerie, our participants attend again to features of a medicinal cityscape. Their reflections aid us in exploring how a pharmaceuticalised cityscape is reproduced through the emplacement of medications and associated promotional materials across various micro spaces with tailored functions – the thoroughfare for promoting particular products associated with the healthy enhanced life; the convenience store for accessing restorative materials to address immediate concerns such as tobacco cravings or hangovers; the pharmacy for accessing regulated substances and addressing long-term health concerns; the domestic home as the primary site for ingestion and the security of having one’s medications at hand; and the internet as a space for information, discussion and self-positioning as critical consumers. Urbanites know the lay of the land and navigate these micro spaces in a manner that not only meets their medicative desires and needs, but also in turn routinises the pharmaceuticalisation of the city as a form of urban commodification.