Social Science & Medicine 55 (2002) 451–465

Habit versus choice: the process of decision-making inhealth-related behaviour

Eva Lindbladha, Carl Hampus Lyttkensa,b,c,*aDepartment of Community Medicine, Malm .oo University Hospital, SE - 205 02 Malm .oo, Sweden

bDepartment of Economics, Lund University, P.O. Box 7082, SE - 220 07 Lund, SwedencLund University Centre for Health Economics, P.O. Box 705, SE - 220 07 Lund, Sweden

Abstract

Social differences in the role of habits in health-related behaviour are explored within both sociology and economics,

where we define habits as non-reflective, repetitive behaviour. The corresponding theoretical perspectives are the

habitus theory, the theory of individualization, and habits as rational decision rules. Sixteen thematically structured

interviews are analysed using qualitative methodology.

Three aspects of habits emerged from the narrative: the association between habits and preferences, habits as a source

of utility, and the relationship between habits and norms. We find that people in lower social positions are more inclined

to rely on their habits and are accordingly less likely to change their behaviour. These differences are reinforced as not

only the disposition to maintain habits but also the tendency to conceive of the habitual as something good seems to be

strengthened in lower social positions.

We also note that the intensified individualization that characterizes current society erodes the basis for habit-

governed behaviour, which may also contribute to social differences in well-being. Finally, we find that the scientific

dialogue has enriched both scientific paradigms, and suggest as a tentative hypothesis that the traditional economic

rational-actor model may be relatively less applicable to those with limited resources. r 2002 Elsevier Science Ltd. All

rights reserved.

Keywords: Habits; Behaviour; Health; Social differences

Introduction

This article focuses on the phenomenon of habits in

the context of health-related behaviour. Decisions can,

in practice, be made in terms of constantly new choices

between different options on the basis of their estimated

value, but they can also be made in terms of implicit or

explicit references to prior choices, to the apprehension

of how things are usually done. We are interested in the

extent to which health-related decisions are a reflection

of such repetitive, non-deliberate choice, and in the

possibility that the prevalence of habits in the decision

process varies systematically across the population. In

other words, we concentrate on the process of decision

making in order to improve our understanding of

health-related behaviour in general and of social

differences in such behaviour in particular.

It seems reasonable to presume that the basic

structure of decision making has implications for the

propensity to change behaviour, in relation to, for

example, the adoption of new dietary practices or

patterns of alcohol consumption. Without denying the

importance of many other factors that influence the

individual’s health-related behaviour, such as external

constraints in terms of time and money, we believe that a

focus on the process of decision making offers new

insights into why some people behave more healthily

than others.

*Corresponding author. Department of Economics, Lund

University, P.O. Box 7082, SE - 220 07 Lund, Sweden. Tel.:

+46-46-2228652; fax: +46-46-2224118.

E-mail addresses: carl hampus.lyttkens@nek.lu.se (C.H.

Lyttkens). Eva.Lindbladh@smi.mas.lu.se (Eva Lindbladh).

0277-9536/02/$ - see front matter r 2002 Elsevier Science Ltd. All rights reserved.

PII: S 0 2 7 7 - 9 5 3 6 ( 0 1 ) 0 0 1 8 0 - 0

This issue is explored by analysing a set of qualitative

interviews from two different scientific perspectives,

namely sociology and economics.1 Despite the difference

in paradigm we find that we largely agree on the

importance and role of habits as well as the way in which

the relative reliance on habits helps explain social

differences in behaviour.

At the same time, the analysis suggests important

ways to enrich future analyses of behavioural patterns

within both paradigms. This result from the scientific

dialogue is partly due to the fact that our object of

analysisFsocial differences in the individual’s decision-

making processFis a somewhat atypical endeavour

from both scientific perspectives. On the one hand, an

economist rarely focuses on social differences in

behaviour while, on the other hand, a sociologist would

not normally choose individual decisions as the analy-

tical starting point.

Sociology and economics on habits

The purpose of this section is to introduce a socio-

logical and an economic perspective on the role of habits

and the relationship between habit and choice in

individual everyday decision making, which will serve

as the framework for our analyses. We are not concerned

with the distribution of particular lifestyles in the

population, but with social differences in the propensity

to rely on different principles of decision making.

When human behaviour and everyday action is taken

as the analytical focus within the sociological paradigm,

these discourses are naturally associated with the

phenomenological approach.2 Within this theoretical

context, the goal-oriented version of rational behaviour

is distinguished from those routine everyday practices

which are meaningful from an individual standpoint

without involving reflections concerning aims, motives

and means (Sch .uutz & Luckmann, 1974; Berger &

Luckmann, 1966; Connerton, 1989). The definition of

habits as rational decision rules in economics (cf. below),

is coincident with an interpretationFwithin the domain

of phenomenological sociologyFof habitualization, in

terms of a process implying a minimum of decision

making and an economy of effort, liberating the

individual from ‘‘the burden of all decisions’’ (Berger

& Luckmann, 1966, p. 53).

Although the demarcation between reflected and

habitual behaviour is normally fluid in the context of

everyday life, where most social practices contain

elements of both reflection and habit, we have found

the focus on the distinction between habit and choice to

be worthwhile in terms of theoretical insights. Similarly,

it is a relevant empirical question to examine whether

habit or choice turns out to be the superordinate

dimension.

From our sociological position (in contrast to

Rational Action Theory), we will proceed by elaborating

two contextual interpretations of habit versus choice

which are both grounded on the respondents’ first-order

constructions. Following our previous theoretical work

(Lindbladh et al., 1996), we approach observable

variations related to social position by drawing upon

Bourdieu’s habitus theory according to which individual

aspirations and apprehensions are induced and attuned

by a set of deeply rooted principles of action (the

structure of habitus) which in turn represent embodied

conditions of existence.3

At the same time, we seek to incorporate the overall

societal level in our analysis. Since we are concerned

with the meaning of habit as a model of human action,

rather than with the determinants or motives of specific

habits, we take an interest in macro-level processes that

have a bearing on the very structure of everyday

behaviour. The notion of habit emerges as an interesting

sociological category in the light of the continued

unplanned trend towards individualization that appears

to be established at a new level in the present stage of

modernity.4 The intense emphasis on individual choice

and rational calculationFwhich is broadly manifested

in overall societal structures and all the way down to the

level of the individual biographyFimplies by definition

a weakening of the position of habitual behaviour. The

habit-guided individual could consequently be classified

as someone who is ill-adapted to the demands of

contemporary society.5

1We share the belief of Evans, Barer, and Marmor (1994) in

the value of multidisciplinary work in this context.2Even though habits have a major influence on human

behaviour, this is a neglected dimension in sociological theory

(Bourdieu & Wacquant, 1992, p. 123).

3The habitus theory is explicitly developed in a critical

dialogue with the rational action paradigm and one of its merits

lies in its capacity to explain: ‘‘why the finalism of rational

choice theory, although anthropologically false, may appear

empirically sound’’ (Bourdieu & Wacquant, 1992, p. 121). Note

that we draw upon a restricted version of Bourdieu’s theory.

See Williams (1995) for a more comprehensive discussion of

Bourdieu in relation to issues of health and lifestyle.4The notion of individualization goes back in time to

Weber’s, Durkheim’s and Simmel’s analyses of the release of

individuals from feudal and religious structures in the emergent

industrial society. Ulrich Bech is one of those who define the

intense wave of individualization as a key process in the present

society (‘‘Risiko Gesellschaft’’). Collective structures (ties to

social class, region, gender roles, etc.) are now being erased due

to structural transformations related to the labour market, the

educational system, welfare policy, etc. (Beck, 1994a, b).5The issue of correspondence between society and different

versions of action associated with different principles of

rationality goes back to Weber’s theory on idealtypical models

of behaviour.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465452

In economics, the presence and persistence of habitual

behaviour has generated an extensive literature. It

covers subjects such as the relationship between past

and present consumption, asset pricing, labour supply,

and the effects on savings and growth (cf., e.g., Becker,

1992; Becker & Murphy, 1988; Bover, 1991; Deaton,

1992; Hodgson, 1998). There are many conceivable

reasons why an individual may experience that he would

obtain higher utility from choosing the same course of

action as he has done in the past. For example, there

may be physiological reasons why past consumption

directly influences the utility of current consumption.

Our primary focus here is on a special class of

habitual forms of behaviour, namely habits in the sense

of repetitive, non-reflective behaviour. In the paradigm

of mainstream, neo-classical economics, the fundamen-

tal reason for such repetitive behaviour is that it saves on

decision costs (Stigler & Becker, 1977).6 To follow a

habit may therefore be a preferable strategy compared

to searching for an alternative by engaging in explicit

choice. Furthermore, because of the complexity and

uncertainty surrounding decisions in the real word,

habits and rules are very likely to be important elements

in individual behaviour (Heiner, 1983; Hodgson, 1997).

Even though decisions by habit may often be

subconscious, it is implicit in the neo-classical approach

that individuals may make decisions about their habits,

and about changing them. Furthermore, a change of

habit is tantamount to an investment in a superior

decision strategy, and it follows that individuals will not

always find it advantageous to change their habits in the

face of small changes in the decision environment. The

presence of social differences in behaviour is also

implicit in this economic model, because one would

expect that people in similar circumstances find it useful

to develop similar habits. For the purpose of our

economic analysis, we adopt this neo-classical view of

habits as rational decision rules as our starting point.7

We will also touch upon a related concept, namely

norms. Norms appear in the neo-classical paradigm as

normatively sanctioned rules of behaviour and are the

subject of a rapidly growing literature (Elster, 1989;

North, 1990; Kreps, 1997; Lindbeck, 1997; Cole,

Mailath, & Postlewaite, 1998). People comply, for

example, with internalized norms because adherence is

felt to be desirable per se and with social norms since it

leads to better treatment by others.

Data and methodological aspects of qualitative analysis

The present study is based on 16 thematically

structured interviews, which were planned and carried

out with the overall aim of investigating the spectrum of

determinants of health-related patterns of behaviour.8

The interview guide included questions about food,

alcohol, smoking, physical exercise, and other everyday

activities related to health, with special emphasis on the

dimension of change. The interviews were of about 2 h

duration and conducted in the respondents’ home. They

were all taped and transcribed. The interview group

comprised men and women in the age groups 25–30 and

45–50 years, who were living in families with their

husband/wife and children.

The respondents had the following occupations:

chemist, cleaner, engineering graduate, garbage collec-

tor, assistant nurse (2), university student, children’s

nurse, industrial worker (2), computer operator, econ-

omist, civil servant in management position, journalist,

office employee, municipal worker.9 The interview group

was ethnically homogenous (Swedish background).

The verbatim transcripts were analysed manually. The

explanation of everyday practices with reference to

habits emerged in the initial coding process as a

recurrent theme. It was accordingly selected as a key

element for analysis. The further analysis of data

proceeded in terms of the familiar procedure of

6There is also a relationship between habits and risk, which is

worth noting, even though this is not explicitly mentioned in

our interviews. In a certain sense, following a habit makes life

less risky, which is beneficial for risk-averse people. Above all,

the individual is well informed about the particular outcome to

which his habit usually leads. He may also know relatively more

about the probability distribution of different outcomes under

the habit strategy. Note carefully, however, that following a

habit does not in general imply less risky behaviour. For

example, the individual may be in the habit of not wearing a

seat belt in his car. The relationship between habits and notions

of risk is discussed further in a companion paper based on the

same set of interviews (Lindbladh & Lyttkens, 2000).7For a critical assessment of the neo-classical paradigm, with

special reference to the importance of habits, cf. Hodgson

(1997, 1998).

8 It is well known that individuals have a propensity to

present themselves (and their actions) in ways that they perceive

to be in accordance with generally accepted behaviour, cf., e.g.,

West (1990) and Williams (1995) on the distinction between

private and public accounts. Performing a second interview on

the same subject increases to a certain extent the possibility to

identify the different forms of narratives. With this in mind,

some repeat-interviews were conducted within both age groups.

More generally, our confidence in the interpretations is above

all related to the fact that we employ a multi-analytical strategy,

where several analyses are conducted, on the same set of

interviews, where different issues are in focus (Bustos Castro, &

Lindbladh, 1999; Lindbladh & Lyttkens, 2000). Cf. also the

concluding remarks on perspective triangulation and footnote

26.9The attentive reader will note that two of the respondents

are not explicitly referred to in the text, the reason being that

their narratives were less telling in relation to the habit–choice

dichotomy. Needless to say, all 16 interviews are included in the

basis for the analysis.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 453

systematic comparisons between the multiple comments

related to the category of habit (including the contrast-

ing category of choice) in order to uncover patterns and

connections.

Since our interest in the category of habitFinitially

grounded on dataFis primarily concerned with its

theoretical significance, i.e., in its potential for explain-

ing at least some of those social variations in health-

related behaviour that are observable in a variety of

quantitative surveys, we assign our methodological

approach to the notion of grounded theory (Strauss,

1987) in its most extensive but at the same time its most

fundamental aspect.

In the first phase of the following analysis, we present

three different aspects of habit that emerged directly

from the narratives: habits and preferences, habits as a

source of utility, and the relationship between habits and

norms. These three themes of habits as a conscious

phenomenon are illustrated separately with a number of

interview accounts and with a minimum of theoretical

interpretation. In the second phase of the analysis, we

move to a more abstract level and the emphasis is now

on explaining the emerging pattern of social differences

among the respondents in relation to the habit–choice

dichotomy. In this analysis, where we seek to identify

potential linkages between the data and sociological and

economic theory, we return to many of the previously

mentioned accounts, as well as some additional data

from the narratives that are now introduced in the light

of theoretical considerations.

The meaning of habit in the narratives

An initial observation is that references to habitual

structures appear as a typical first-hand explanation of

everyday behaviour. Among the diversity of examples,

Elin (journalist, younger generation) explains why she

seldom eats fruitFeven though she is well aware of its

allegedly positive effects on healthFby the fact that she

is not ‘‘in the habit of having an apple’’. Her alcohol

consumption is restricted to the weekend which she

accordingly perceives as a natural consequence of the

condition that she ‘‘has never got into that habit’’ (i.e.,

drinking on weekdays). Bengt (engineering graduate,

older generation) explains the fact that he does not

exercise (apart from everyday activities like gardening)

by saying: ‘‘I never got into the habit of thinking that it

was natural to exhaust oneself. If I had to put the blame

on anyone, it was just something that I didn’t learn at

home.’’ Correspondingly, smoking is justified with

reference to its status as a deeply rooted habit. For

example, Lotta (children’s nurse, younger generation),

subordinates the importance of craving for a cigarette

and emphasises instead the binding force of habit: ‘‘I

mean, I can smoke although I am not dying for a

cigarette. Just because well, I usually do it.’’ Lotta here

makes a distinction between her physiological addiction

and her dependency on routine behaviour.

Habits and preferences

There is an explicit tendency to equate habits and

preferences. The habitual and the good are two

dimensions that are frequently mentioned side by side.

‘‘I always buy minced pork but it is not just because it is

cheaper. In my opinion, it is actually tastier,’’ says Mona

(assistant nurse, younger generation) and continued, ‘‘I

am not fond of minced beef and things like that. But

that is because I am not used to it.’’ Nils (industrial

worker, older generation), explains his preference for

traditional Swedish dishes in the following way: ‘‘One is

used to eating itFsince my mother used to make

itFand then it has continuedF so I think it has a good

taste.’’

In particular, references to childhood and adolescence

for the grounding of today’s taste preferences are usually

seen as something which goes without saying and

consequently need not be explained further. The young

woman who always buys high-fat milk products makes

clear that it is not that she cannot drink low-fat milk but

rather the fact that: ‘‘You have had it since you were a

small child. So that’s it.’’ Mona emphasises in her

account of her meals that; ‘‘it is always roast on

Sundays’’. She explains that this is something brought

from her childhood (and it is moreover practically the

only element of order in her chaotic everyday life).10

The close link between habits and preferences also has

implications for the propensity to change one’s beha-

viour. Let us turn to the narrative of Kalle (computer

operator, younger generation), which illustrates how

two aspects of decision makingFhabitual preference

versus financial considerationsFare ranked within the

field of consumption. Whenever he buys napkins,

kitchen roll paper, and similar products he claims to

choose on the basis of price-related considerations.

However, he firmly asserts that the question of price is of

no importance to him when he is buying ‘‘sausages,

bread and things like that’’. He answers the follow-up

questionFwhat are in that case the major determi-

nants?Fby saying: ‘‘then it is what I always have

eatenyI have been eating honey on my bread since I

was born and I still consume at least five sandwiches a

day. It has to be ‘Lockarps fina’ [a particular brand of a

common type of bread]. And the honey must be of the

same brand as it always has been’’.

Of course, we could not predict how Kalle’s behaviour

would be affected by a drastic increase in the price of

10Kerr and Charles (1984) noted that the significance of the

Sunday dinner tended to increase in poor families where this

institution attained a special value as a symbol of status and

well-being.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465454

‘‘Lockarps fina’’. However, it seems that financial

aspects influence his choices in areas where there are

no ingrained habits and accordingly no beforehand

given preferences. For certain other goods, the disposi-

tion to reproduce established patterns of behaviourFbuy-

ing what he has always bought, etc.Freduces the

potential influence of financial considerations. In all

likelihood, the higher degree of inertia implied in these

latter cases will also be present in the face of, e.g.,

information on the health effects of these products.

Habit as a source of utility

The issue of why and when individuals are prepared to

try to change their habits leads us to another of the

themes that emerged from the accounts: habits as a

potential source of utility. This theme is illustrated by

the narratives of Robert and H(aakan. It is not an

accident that these two young men were specifically

attentive to the importance of habit and verbalized their

thoughts concerning the intrinsic structure of their

behaviour. Both of them had fathers with heart

problems and they were seriously concerned about their

own health. It is symptomatic that a process of reflection

is initiated when everyday routines that have been taken

for granted are for some reason interrupted.

Robert (municipal worker, younger generation) is well

aware of the health-related threats associated with

several of his habits, and he would truly want to change

in different ways. For instance, he would want to begin

exercising, to stop smoking and to reduce his consump-

tion of alcohol. He takes, however, the changes ‘‘bit by

bit’’, which from his point of view means that he denies

himself the use of a car only when he feels like biking.

His primary aspiration is to avoid feeling restrained: ‘‘I

don’t like to feel pressure. I want to make a habit of it. I

shouldn’t have to feel that I am forced to do it. It should

be a habit so that it makes you feel comfortable,

mentally and in all other ways.’’

Robert’s account provides a clue regarding what

might be the magical power of habit. He sees his habits

as an integral part of his self-identity, something that

exists by itself without any demands whatsoever. He is

aware of the fact that breaking off a habit involves

major investments of energy. The point is thatFfrom

Robert’s point of viewFthis is tantamount to external

restraint, which, in turn, is inconsistent with his personal

notion of comfort. The non-compulsive habit is so

strongly associated with the pleasant that it is not easily

abandoned.

A different view of habits is found in H(aakan’s

narrative (economist, younger generation). He describes

the phenomenon of habit in terms of ‘‘something which

happens automatically, it is not anything that I think

about any more’’Fand adopts as an illustration the act

of putting on a safety belt in the car. From his own

experience, he has realized like Robert that it is ‘‘so

extremely difficult to get out of habits you have got

into’’. He is a health-oriented person in the sense that he,

for example, pays regard to much of the information

about healthy food. Within the field of diet, he attempts

to make changes ‘‘in a long-term view. There is no point

in eating in a healthy manner for one month or so and

then giving it up because it isn’t much fun’’. H(aakan

characterizes himself as a person ‘‘who use to follow

health trends’’ but he adds ‘‘it is not certain that you

include all of them among your habits’’. The last

statement could be seen as an indication of an active

stance towards established habits and the continuous

flow of new information concerning health-related

lifestyle factors.

There is a similarity between the insights of the two

men regarding the intrinsic inertia of habits. Both of

them also argue that a change in behaviour may require

that the new behaviour is turned into a habit. We can,

however, note two major distinctions. Compared to

Robert, H(aakan’s set of habits is much more in line with

the current medical notion of what constitutes healthy

behaviour. More important in the present context,

however, is the fundamental difference in their ways of

tackling the phenomenon of habit as such. First,

Robert’s notion of habits as something pleasurable is

conspicuously absent in H(aakan’s narrative. Secondly, it

becomes increasingly evident that H(aakan represents a

divergent attitude in his account of his fancy for ‘‘snacks

in different shapes’’. He tries to keep himself to popcorn

which he believes to be the least unhealthy of these

products. ButFhe addsF‘‘sometimes you have to

indulge yourself by eating crisps’’. In connection with

this confession he makes the following distinction: ‘‘It is

perhaps not so much a bad habit as a weakness.’’ This

suggests that for H(aakan it is not desirable to present

oneself as a person who is a slave of habitFthat

subordinating oneself to habits is an improper kind of

behaviour. If the behaviour in question is defined as a

‘‘weakness’’, rather than a ‘‘bad habit’’, it appears

instead as a self-chosen phenomenon, something im-

plicitly more acceptable.

The tendency to classify habitual behaviour in negative

terms could be assumed to function as a change-

promoting mechanism. Pleasurable connotations asso-

ciated with habitual structures, on the other hand, will

inevitably render the process of change more difficult.

Habits versus norms

In many situations it seems reasonable to expect that

norms exert an important influence on individual

behaviour. In the first reading of the interview material

we observed, however, that explicit references to norms

in connection with accounts of drinking patterns, dietary

preferences, etc., were fairly few, whereas the spirit of

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 455

habit quite literally permeated the material. On closer

reflection, it appears that norms and moral attitudes are

indeed important dimensions although these factors do

not appear as alternative governing mechanisms in

relation to habits. Instead, it is moral attitudes towards

the ubiquitous notion of habit-governed behaviour as

such that turn out to be important.

In the previous subsection, we saw that the habitual

approach to life could be valued as something princi-

pally beneficial and worth striving for (Robert) but it

could just as well be judged as a manifestation of

passivity and the absence of free will and, accordingly,

as something that one would rather seek to overcome

(H(aakan). Robert’s positive view of habit was rooted in

the dimension of pleasure rather than morals. In

contrast, H(aakan, was inclined to include normative

conceptions in his version of habit and showed a

tendency to consider the habit-governed individual in

disparaging terms. This kind of moral attitude will

inevitably affect the role that habits could be expected to

play in everyday decision making, irrespective of

whether it is verbalized or not.

A similar picture emerges in the few interviews where

explicit normative judgements concerning particular

habits could be noted.11 For example, Birgitta (civil

servant in management position, older generation), who

personally stopped smoking some years ago, now talks

about other persons who she really thinks ‘‘ought to do

something about it for their own sake’’. She sees it as

‘‘humiliating to be addicted’’ and this was her own

primary reason for giving up smoking. In contrast,

Lotta answers the question on the importance to her of

cigarettes by stressing the fact that ‘‘you have to have

them with you all the time’’. Without moral undertones

she concludes: ‘‘So it means a lot. Because you are

addicted. You have to have them.’’ Karl (chemist, older

generation) explains the principal reason behind his

decision to stop smoking as follows: ‘‘Think that your

children could become fatherless because you had

smoked yourself to cancer. It gave me a totally new

perspective. Nothing can be done about the fact that I

am going to die but I don’t have to do it to myself.’’ The

presence of a high valuation of individual independence

and responsibility (and implicitly deliberate choice) is

likely to work as an additional source of pressure, which

may make an energy-demanding change worthwhile.

This motivation may well be stronger than the prospect

of long-term health benefits.12

The phenomenon of habitFan interpretation from the

perspectives of sociology and economics

The connection between behaviour and health could

largely be defined as common-sense knowledge. All our

respondents were accordingly familiar with the health

risks associated with smoking or a large fat consump-

tion, as well as the health-promoting value of vegetables

and physical exercise. In everyday practice, however,

other conditionsFsuch as the underlying model of

decision makingFset the odds for this knowledge to be

translated into action and change.

In the previous section, we saw that individuals are

aware of the presence and importance of habits.

Sociology and economics agree on the fundamental

importance of habits as arrangements for facilitating

decision making, as a basic necessity for making daily

life manageable. Hence we would in general expect all

individuals to more or less consciously perceive their

habits as something which contributes to the economiz-

ing of resources, even though it is very seldom that this is

expressed in terms of reducing decision costs. When

habits are motivated and justifiedFfrom a common-

sense perspectiveFwith reference to their mere existence

and, in particular, when they are explicitly linked to

their perceived tenacity, this could be interpreted as an

everyday standpoint that accords with both sociological

and economic theory. At the same time, it is also

obvious that there are important differences in the way

in which individuals relate themselves to habits. In this

section, we focus specifically on the observed correlation

between social position and orientation towards the

habit–choice dichotomy.

Habits as habitus products (sociology)

We observed a common tendency to account for

everyday behaviour with reference to whether or not one

is accustomed to act in a certain way, or has grown to

see something as natural. Taken together with the close

connection between preferences and the structure of

habitFwhich is present irrespective of which area of

everyday life we focus onFthis position could accu-

rately be described as a common-sense version of the

habitus theory.

The habitus theory is ultimately a theory of practical

sense that accounts for the logic and reason of everyday

practices. The structure of habitus is engendered by

practice and directed towards practical functions, which

simply means that people learn by their actions to

recognize the limits of their potentialities, and that they

consequently adjust their efforts to this experience-based

estimation of chances. Habitus is the mechanism that

converts objective conditions attached to a certain

position in the social structure into subjective aims and

11Here there is a fluid demarcation between efforts to follow

a particular set of normative values and measures taken in

order to meet the desire to present oneself to others in a

particular way.12Furthermore, traditions and habits are closely related

phenomena, and tradition is saturated with moral meaning.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465456

motivations in accordance with the principle ‘‘to make a

virtue of necessity’’ (Bourdieu, 1986, 1990).

To act in accordance with the practice-generating

principles (habitus), which are inscribed in body and

mind, means to act with naturalness and confidence.

Against this background, we can understand the

predilection for affirmative experiences and values that

fit into previously established schemes of perception. We

can also see why a sense of well-being is normally

inherent in the customary way of life, in the same way as

to be at home with something is synonymous with

feeling unconstrained. In other words, within this

theoretical context, the ties to dispositions grounded at

an early stage of life (which tend to reproduce and

reinforce old patterns of behaviour and inherited sets of

preferences) are by definition a universal and inevitable

phenomenon.

To say that everyone acts in accordance with their

habitus, however, is not the same as saying that all

individuals have a similar attitude towards habit per se

or that they are equally disposed to sustain habitual

standards of behaviour. Marked differences in this

respect were also noted among our respondents. The

primacy of habit tended to be associated with indivi-

duals in lower social positions, whereas the notion of

choice emerged as a primary category among individuals

in higher social positions. A number of examples also

demonstrated that references to the category of habit (or

choice) was applied in various fields of everyday life in a

consistent manner, i.e., the same stance seemed to

characterize the respondent’s accounts of the different

themes which were brought up in the interview.

Among the primarily habit-oriented respondents, we

could for example notice Kent (industrial worker,

younger generation) who answered the question regard-

ing why he was living in housing area X by referring to

the fact that he had grown up there rather than to any

qualities in this particular environment. His disinclina-

tion to use the safety belt was attributed to the fact that

‘‘there was no talk of using a safety belt’’ when he grew

up. He also implied that he found the question on which

principles of choice he followed when making purchases

at the supermarket somewhat strange, by repeating in a

surprised tone of voice: ‘‘how do I choose?’’ The follow-

up question (‘‘yes, which factors are you considering’’)

was answered: ‘‘It is generally the same, it is always the

same milk and the same butter.’’ The question whether

he had made any changes in his dietary habits was

answered negatively: ‘‘No it is mainly the same.’’ In all,

Kent’s narrative was consistently organized around the

notion of the same as another way of expressing a

reliance on and preference for the habitual.

The category of habit orientation is further exempli-

fied by the substantially convergent narratives of Nils

(industrial worker, older generation) and Per (garbage

cleaner, older generation). Both talked about their

professional careers, not in terms of choice and

planning, but rather as something which ‘‘just turned

out to be’’. Moreover, both of them were equally

disinclined to give up the food preferences that they had

established at an early age. Similarly, the common short-

term perspective was described by Nils in three steps. He

stated as a fact that he did not use to make plans with

reference to long-term prospects, declared that in his

opinion it was ‘‘dull to live like that’’, and concluded by

saying that non-planning was ‘‘the right way of living’’.

This narrative is a perfect illustration of how cognitive

perceptions of how things are, matters of appreciation

and normative judgements are mutually adjusted and

tied together in coherent structures.

Lisa (university student, younger generation) can be

taken as an illustration of the converse standpoint. In

different parts of the interview, she returned to and

stressed the importance of individual choice: ‘‘That I do

something that I want to do, that I have chosen myself.

Something I really want.’’ Similarly, Birgitta (civil

servant in management position, older generation)

systematically underlined the value per se of the

opportunities to make personal choices. Note, in

particular, the final comment in the quotation be-

lowF‘‘to choose to remain in somethingy’’Findicat-

indicating that the maintenance of a habit was also

enclosed within her definition of choice, which is again a

good illustration of consistence:

These constant changes and all the demands, this

massive information y and the need to choose. It is

hard. And at the same time it is an opportunity. If

you can find a way y It is important for me to feel

that you have the opportunity to influence what you

like to influence, the opportunity to choose and

change to do something else, if that is what you need,

to choose to remain in something that you like.

Even though most of the individuals in our study

referred to certain patterns of behaviour as something

they had ‘‘inherited’’ from their parents, the significance

of this phenomenon could vary. For example, Karl

(chemist, older generation) mentioned that his food and

alcohol preferences were very similar to those of his

wealthy parents. However, this was not referred to as a

dimension of central importance for his identity. Instead

he preferred to characterize himself in the following way:

‘‘I am a person who makes choices and looks forward.’’

By contrast, we can return to Kent who justified his

dietary preferences, his overweight, his whole way of

living, with reference to the fact that he was pleased with

everything as it was: ‘‘I am born like this.’’

The definition of oneself as a person ‘‘who make

choices and looks forward’’ or references to the fact that

‘‘I am born like this,’’ represents two extreme versions of

self-identity, that are rooted in and are expressions of

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 457

different orientations towards the future, and which are

in turn associated with a disposition towards either

change or stability. The recognition of these diverging

principles of action contributes to an understanding of

social variations in the extent to which health-related

behaviours have been modified in accordance with

health information campaigns. Whereas the emphasis

on flexibility and reorientation may be interpreted as a

reflection of a habitus that is the product of conditions

involving a continuous adaptation to everyday situa-

tions involving cost–benefit calculation, the systematic

emphasis on the value of constancy and living in the

present, may, on the other hand, be defined as an

adjustment to the long-term experience of restricted

options (Lindbladh et al., 1996).

From a privileged position, most situations are

automatically seen as cases where choices can be made.

It goes without saying that opportunities to make

explicit choices (in terms of a calculated decision to

introduce change) are not always restrained by current

external hindrances. It is for example obvious that Lotta

is not prevented from stopping smoking and that

nothing stops Kent from making an effort to loose

weight. However, internal subjectively constructed

barriers firmly rooted in prior non-chosen social and

economic conditions can be an equally powerful

restricting mechanism. Bourdieu often returns to the

relationship between the conditions and demands of the

present and the primary conditioning structure (habitus)

produced by experience of the past. Hence, a disinclina-

tion to invest energy in a project of change (with

reference to for example smoking or diet), is conditioned

beforehand by schemes of perception and appreciation

that are moulded by a habitus adjusted to narrow

margins of choice that make it more natural and

comfortable to keep to things as they are.

The rationale for Kent’s non-planning or keeping to

the same strategy was overtly related to his everyday

practices conditioned by a general lack of resources. In

his view, one should not make choices and plans. He

made his position clear by referring to his experience

that if efforts in this direction had occasionally been

made ‘‘it never turned out that way anyway’’. From his

point of view, it is consequently not only meaningless,

but moreover irrational, to consume energy by trying to

calculate the benefits of different choices, since the only

expected result of these efforts is disappointment

(disutility). Compare this persistent principle of ration-

ality with the statement: ‘‘there is still a sort of economic

calculation in the unwillingness to subject existence to

economic calculation’’ (Bourdieu, 1986, p. 180).

The observed relationship between social position and

principles of decision makingFin terms of the disposi-

tion to lean upon previously established habits versus

the disposition to make calculated choicesFcan thus be

elucidated within the habitus theory. In order to further

clarify this theoretical linkage we can turn back to the

notion of habit as a source of utility. In compliance with

a definition within the economic paradigm of habits as

rational decision rules, it seems reasonable that decisions

in terms of choice are in general more energy-intense

than habitual decisions, and that this is valid for all

individuals regardless of their social position. But the

degree of utility, on the other hand, attached to habit

(and conversely, the degree of disutility associated with

choice) is basically influenced by the objective scope of

decision making and is accordingly the dimension which

showsFand is the source ofFsocial variation. When

the amount of resources (material, social, educational,

etc.) have been constantly scarce and, consequently, few

opportunities to choose between different alternatives

have been offered (as in the case of Kent and Lotta) the

dependency upon the energy-saving habit will increase.

In contrast, a continuous exposure to daily situations

where calculated choices are systematically required,

grounds the disposition to choose as a natural and

instinctive act, which inherently means that the costs of

energy related to this kind of decision are substantially

reduced (more on this below).

We have demonstrated how this latent relationship,

becomes manifest, above all, at the level of preferences.13

Kent was expressly pleased with holding on to ‘‘the

same’’. Remember also Robert (municipal worker), who

explained the necessity of turning new behavioural

patterns into habit with reference to the sense of well-

being associated with the non-compulsive status of

habitual structures.14 Those who have learned by

practice to rely on habit (which is another way of

saying: by conditions of necessity) can also make this

underlying disposition visible in other ways (the same

goes for choice). As we have seen; references to self-

image (e.g., I am born like this) could be one clue, while

openly declared normative views15 (the definition of a

habit-directed way of leading once life as good or bad)

could be another.

In conclusion, the primacy of habit over choice (or

vice versa) emerges as a significant habitus disposition

13As expected, since the unconscious structure of habitus ‘‘is

expressed in and through ‘taste’’’ (Williams, 1995).14Note that the analysis is based on a homogenous group of

respondents in the sense that all had family and work. If we had

also included individuals in marginal positions, the ties to

habitual structures would have been even more distinct

(Lindbladh & Bustos Castro, 1999).15Note here the fluid division between social norms and the

notion of normatively regulated action. Whereas social norms

tend to be weakened in a society marked by a dissolution of

collective identities, there is no reason to expect a reduction of

morally regulated action referring to the behaviour of solitary

actors (Habermas, 1984, p. 85). On the contrary, the extended

focus on individual choice and responsibility tends to increase

the burden of individual guilt.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465458

(shaped by experience, reflected in appreciation and

evaluation, and put into action within different fields of

everyday life). Needless to say, the existence of class-

related differences regarding principles of decision

making is hardly a new phenomenon. As noted before,

however, the socially polarized tendency towards

decisions in terms of habit or choice assumes a special

meaning at the present stage of modernity and may serve

as a potential mechanism for the generation of inequal-

ity (see below).

Habits as rational decision rules (economics)

The resource-saving aspect of habits implies that the

relative importance of behaviour governed by habits-

Frather than deliberate choiceFwill vary among social

groups. It seems reasonable to expect that the more

resources that an individual has at his disposal, the more

likely he is to engage in deliberate choice and the less

likely he is to rely on habits. Explicit decisions entail

costs of gathering and processing information, weighing

costs against benefits, etc. For any given anticipated

benefit in terms of a superior outcome, the better-off in

society are more likely to find this worthwhile.16 This

prediction is confirmed by our material, where there is a

social gradient in the propensity to explain one’s

behaviour with reference to habits. For example, we

saw above that for Kent (industrial worker), habits are

the primary explanation for his own behaviour, while

Karl (chemist) defines himself as a person who makes

choices and plan for the future.

Behaviour governed by habit will also be relatively

less likely to change. To change a habit entails an

increase in decision costs and it will only be undertaken

if the external change is of a sufficient magnitude.17

Hence the fact that Kalle is not concerned about price

when he buys certain goods could be seen as a rational

attitude in the face of ‘‘small’’ price changes. This

reasoning also implies that low-income earners will be

less likely to change their behaviour, since they are more

apt to rely on habits.

Furthermore, we can expect high-income earners to be

more prone to change their habits because they can

better afford to invest in a superior decision rule. For

example, H(aakan takes an active stance when he argues

that he follows health trends but does not necessarily

include all of them among his habits. Additionally, as

noted above, it seems likely that someone who is well off

in terms of resources will face lower costs for making

calculated decisionsFincluding the decision to change a

habitFbecause they are more familiar with that

decision-making process.

The social differences in the decision process will tend

to be self-reinforcing: if high-income earners incur low

costs for explicit decisions, this will strengthen the

tendency to make them relatively less reliant on habits.

In fact, as already hinted, the logic may be taken one

step further. Calculated decision making could in a sense

be argued to have turned into a habit for those with

ample opportunities for deliberate choice. For them, the

cost of making calculated decisions may in certain

situations seem lower than the costs of relegating the

decision to the domain where things get done ‘‘by

habit’’. It could be difficult for such an individual to

decide what ‘‘the non-calculated decision’’ would be,

and he would find the idea of abstaining from calculated

decisions uncomfortable. Hence, in a general and

subjective sense, the cost of doing things by habit could

be quite high.

Hence we may conclude at this point that the less well-

off in society are less likely to change their behaviour in

response to, for example, a health information cam-

paign. This is partly due to their greater reliance on

habits and partly because they are less likely to change

these habits. Remember, for example, how Robert

expressed great difficulties in trying to amend his

behaviour. This may be contrasted with Lisa (student,

younger generation) who notes that ‘‘if new information

turns up, it will influence me’’.

Even if individuals are aware that their habits are

resource-saving, it does not necessarily mean, however,

that they take a rational-decision view on the formation

of habits. Among our respondents, H(aakan comes closest

to an explicit stance regarding a change of habits that is

in accordance with a straightforward economic logic at a

conscious level. When he suggests that it is ‘‘not worth

it’’ to eat healthily for a while and then give it up, the

most natural interpretation is that he is well aware of the

waste of energy involved in recurrent changes in

behaviour. He is also aware that the least costly way

of maintaining a healthy life style is to turn it into a

habit. We could furthermore interpret H(aakan’s position

as a recognition that the establishment of a healthy habit

may be a rational way to overcome weakness of the will

(Elster, 1985).

16 Income is useful, e.g., in relation to markets for informa-

tion. Education expands the individual’s resources and/or

reduces the cost of deliberate choice by providing training in

rational decision making. The prediction that someone with

more resources will be more prone to invest in a more costly

decision process, ceteris paribus, appears relatively straightfor-

ward: with more resources (lower marginal utility of income,

etc.), it is less of a sacrifice to devote resources to the decision

process. In contrast, it seems doubtful whether any similarly

uncontentious a priori notion can be formed with respect to

systematic differences in the expected benefit from making

choices rather than following a habit. Note also that the

marginal utility of time could be higher for high-income

individuals.17Conversely, no increase in cost is implied for a change of

behaviour if that behaviour is governed by calculated choice

anyway.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 459

In contrast to H(aakan, as we have seen, Kent was

surprised at being asked how he went about making

choices at the supermarket. It is hardly conceivable that

he would see a change of habits as a search for the best

solution among different options. One explanation for

this is the relationship between habits and preferences,

to which we will return. Another interpretation is

suggested by the statement of Birgit (cleaner, older

generation): ‘‘We get by. You don’t have to be

immensely rich. I am satisfied if I have enough to get

by.’’ This suggests a concern with finding acceptable-

Frather than the bestFsolutions to everyday pro-

blems, i.e., ‘‘satisficing behaviour’’. Habits would be a

natural part of an instrumental strategy of bounded

rationality, where individual action is purposeful but not

optimizing (Simon, 1987a, b; Hodgson, 1997). While

Hodgson (1997) has suggested that optimization is

applicable only to a special class of situations, our

material suggests that the optimizing framework of neo-

classical economics may be relatively more relevant for

some individuals than for others. A tentative hypothesis

would be that satisficing behaviour is more prevalent

among those with limited resources who ipso facto have

fewer opportunities for choice.

While almost no individual in our material is explicit

about habits as a means of reducing decision cost, there

are some examples of explicit value judgements concern-

ing habits. The analytical status of these normative

attitudes is a question of considerable theoretical

interest, and it seems likely to affect the relative strength

that we should accord this factor. In the sociological

perspective, the individual’s valuation of habits as such

reflects his conditioned relative reliance on habits. For

an economist, in contrast, the normative views could

represent an independent explanatory factor. For

example, one could argue in relation to Robert, that a

habit is not just a matter of low decision costsFthese

low decision costs also figure as an independent factor in

his utility function. However, the fact that such

additional factors may be so easily incorporated in the

neo-classical paradigm is a temptation to which one

should not necessarily always yield. An alternative

interpretation is that the normative statements are a

manifestation of the fact that people are intuitively

aware of the energy-saving aspect of habits (a latent

structure). The case for the latter interpretation is

strengthened by the fact that it seems to provide the

best explanation for the observed tendency towards a

social gradient in the appreciation of habits, with a more

negative attitude being found among the higher social

classes.18 Obviously the more you rely on energy-saving

habits, the more this will be manifested in a positive

attitude towards habit-governed behaviour.

Finally, the most prevalent of the explicitly mentioned

aspects of habits in our interviews is the conspicuous

and close association between habits and preferences.

This means that for our purpose, the structure and

formation of preferences is an important object of

analysis, in contrast to the approach in most mainstream

economics. It is obvious from our material that one has

to acknowledge that habits qua experiences help shape

our current preferences, confirming the suggestion by

Becker that ‘‘y the evolution of preferences out of past

experiences seems far more intuitive [y] than the opposite

assumption so dominant in economics that preferences are

independent of the past’’ (Becker, 1992, p. 340).

The association between habits and preferences has

obvious implications for the propensity to change

behaviour. It is likely to add to the already inferred

reluctance of an individual to change those behavioural

traits that are associated with habits. Remember Kalle’s

standpointFfor him, one particular brand of a common

type of bread is a good that is significantly different from

other brands of the same type of bread.

One possible representation of the association be-

tween what we are in the habit of consuming and what

we find pleasurable is the economic rational addiction

model where the stock of previous consumption may

increase the marginal utility of current consumption.

The higher the individual’s discount rate, the more likely

it is that past consumption will have a positive effect on

present consumption (potential addiction) (Becker &

Murphy, 1988; Becker, 1992). Since people with more

education are likely to have lower rates of discount

(though the direction of causality is unclear) they are

also less likely to develop such an association between

past and present consumption.

It is obvious in our interviews that the link between

preferences and habits is something of which people are

generally aware. Some respondents (notably H(aakan and

Robert) also express an awareness that habits may be

changed but that these changes are costly. The logical

implicationFfrom an economic perspectiveFis that it

should also be realized that it is possible to make an

investment with the intention of changing both habits

and one’s preferences.19

Social differences in the propensity to change habits

may be strengthened by considerations of the transi-

tional period before a new habit has fully replaced an

18A comparison may, however, be made with the fact that

individuals tend to hold ethical views that are in accordance

with their self-interest (Elster, 1996), and try to rationalize their

behaviour (Kreps, 1997).

19The notion that the individual may decide to influence, e.g.,

his future utility from consumption is embraced by much of the

economic literature on habitual behaviour. One can also go one

step further and assume that meta preferences are stable and

that rational actors take full account of the relationship

between past choices and current preferences. Cf., e.g., Becker

(1996, Chapter 1), for such a general framework.

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old one. If the association between habits and prefer-

ences is sufficiently strong, it could be argued that there

is no difference in experienced utility between the two

habit-governed steady states. This will be realized by the

rational individual. At the same time, the individual may

also expect to experience a transitional period of reduced

utility when one set of preferences is being exchanged for

another, before he has become accustomed to the new

ones. A well-off person has greater opportunities to

compensate himself during such a transitional period by

increasing consumption expenditure in different areas.20 He

can also afford more high-quality products and activities.

Hence he can reasonably expect the temporary loss in utility

to be less than that expected by a poor person.

It seems fair to say that the association between habits

and preferences does not necessarily invalidate the

economic rational-actor perspective. It may yield

testable predictions regarding social differences in

behaviour, which are consistent with our empirical

findings. However, for some individuals, preferences

and habits seem so intimately connected that a change of

paradigm is suggested. The rational-choice point of view

is close at hand for a person like Elin (journalist), who

explained that. ‘‘It is not that we think that we have to

eat wholemeal bread to avoid cancer but you still have

the thought in the back of your mind about how you

lead your life.’’ On the other hand, Kalle clearly does

not see before him a situation where he would

voluntarily prefer to change to another kind of bread.

The fact that some people are unwilling to perceive a

change in habits in the ‘‘rational’’ perspective could be

accommodated within the economic paradigm. They

may be assumed to be, for example, myopic or

uninformed. However, rational considerations in the

tradition of neo-classical economics are not the sole

basis for decision making. For example, proponents of

the ‘‘old’’ institutional economics viewed habits as the

fundamental source of preferences and of rational

choice, all ‘‘y ideas, including beliefs, preferences, and

rational modes of calculation, were regarded as evolu-

tionary adaptations to circumstances, established

through the acquisition of habitual propensities’’

(Hodgson, 1998, p. 178). This almost brings us back of

course to the sociological view of habits. Once again, it

seems reasonable to suggest as a tentative hypothesis

that the neo-classical paradigm is relatively less likely to

be applicable to those with limited resources, who rely

more on habits and therefore seem likely to exhibit a

closer association between habits and preferences.

Habit versus choiceFan interpretation in a macro-

structural context

The extended and intensified process of individualiza-

tion inherently implies that the proportion of life

situations ‘‘which are fundamentally closed to decision

making is decreasing’’ (Beck, 1994a, p. 135). Hence, it

follows that whereas the category of choice is perfectly

consistent with the individualized society, the category

of habit represents instead a typical case of Ungleichzei-

tigkeit.21 This development also entails the definition of

calculated choice as the legitimate form of behaviour,

and those who do not act in accordance with this

principle tend to be viewed as indifferent and undeser-

ving people.22

The trend towards individualization also emerged as a

central dimension of the respondents’ perceptions of

social change. ‘‘These constant changes and all the

demands, this massive information y and the need to

choose. It is hard. And at the same time it is an

opportunity’’ (Birgitta, older generation). ‘‘There are

other demands on people today. Formerly one could drift

with the stream’’ (Lisa, younger generation). Kalle

(younger generation) who underlined that the course

of events was entirely his ‘‘own choice’’, missed the past

when ‘‘one got proper food’’ (home cooking) and when

‘‘conditions were simple and one was pleased with this’’.

The major principle of the present period was in his

experience, the ‘‘demands on oneself’’ (in the sphere of

work and family) which he perceived as an important

source of stress. If we listen to Birgit (cleaner, older

generation), we can moreover understand how the

continuously increased sphere of individual choice and

responsibility, could be primarily perceived as a burden.

Birgit’s attitude could be classified as a consistent short-

term perspective. She pointed out that no energy was left

in her daily life to make plans for the future and said

that she had ‘‘her hands full just thinking about the

present, and seeing that everything works as it should’’.

Birgit meant that society had ‘‘become harder’’23 and

elucidated this statement in the following way: ‘‘you have

to think more nowadays, you can’t trust people today as

20 It is reasonable to assume that individuals strive to arrange

their consumption pattern so that they can avoid temporary

reductions in the overall utility from consumption. It has been

experimentally observed that individuals prefer an improving

sequence of events and to spread events evenly (Loewenstein &

Prelec, 1993).

21The notion of Ungleichzeitigkeit (Uncontemporaneity) was

introduced by the German philosopher Ernst Bloch (1977).22Cf. the dominant designation of smoking (at a point in time

when the majority of smokers belong to the working class) as

irresponsible and vulgar behaviour, which is related to the fact

that individuals in dominant positions possess the symbolic

capital needed to set the standards for the legitimate and

desirable way of living (Poland, 2000).23 ‘‘The hard society’’ was a recurrent formulation in the

interviews, often related to increasing inequalities and/or

growing physical violence. These examples indicate a society

marked by a decreasing degree of social cohesion, where the

sense of trust is undermined, and once again bring individual

responsibility to the fore.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 461

you could at that time y You can almost expect

anything to happen. So it is a bit more insecure today

than it was before’’.

At the same time, an important function of habits is

that they provide ‘‘a structuring medium for the

continuity of life across different contexts of action’’

(Giddens, 1994, p. 101). This means that habitual

structures (in terms of daily routines) have a major

psychological significance and that the tendency to

experience the presence of habits as a security-promot-

ing structure (Berger & Luckmann, 1966) reasonably is a

universal phenomenon (just as habits generally function

as an energy-saving mechanism). It seems moreover

likely that rapid technological and institutional changes

in society, in combination with the reduction in binding

traditions and pre-determined models of behaviour,

increase the value of habits as security enhancing

factors. The more the dimension of familiarity and

consistency is sapped, the higher the valuation that we

could expect in relation to its residual fragments. The

primary issue here is whether the disinclination to

change one’s habits (as well as the overt positive view

of the habitual features of everyday life) should also be

interpreted in relation to these overall societal changes.

Could for example Kent’s systematic expression of his

preferences in terms of taking a fancy to ‘‘the same’’,

Kalle’s strong dependence on the Lockarp bread of his

childhood, or Mona’s ambition to serve the joint of

roasted meat every Sunday, also be understood as a

manifestation of a fundamental yearning for security in

a society marked by the continuous dissolution of

collective structures?

This interpretation implies that there is inevitably a

fundamental value in retaining habits but as was noted

above, this value seemed to be particularly evident

among individuals in lower social positions. In contrast,

Lisa (university student, younger generation) who

certainly recognized the association between her daily

habits and her sense of security, added: ‘‘it [habits] must

be combined with other things so that it doesn’t feel too

protectedFtoo small a world’’. Once again we meet the

tendency to judge the habitual as something relatively

less desirable which is typically associated with higher

social positions.

Here we encounter two intersecting dimensions. On

the one hand, contemporary society’s organizing prin-

ciples and dominant mentality inevitably affects us all.

Within this context, it seems likely that greater weight in

the near future will be attached to well-established

habits as a reaction to structural processes which make it

increasingly difficult to retain stability and continuity.

On the other hand, habits are just one way to try to

create some security for yourself in a changing world.

For the affluent, there will always be alternative ways of

dealing with the negatively perceived implications of

individualization, whereas for individuals in disadvan-

taged social positions, sticking to old habits may be

almost the only means available to create some sense of

security. Taking this line of argumentation one step

further, one could moreover envisage how the very

process of grounding and maintaining everyday routines

becomes a matter of long-term planning and investment

in calculated decisions (to sustain a comforting habit),

which again implies a relative disadvantage for indivi-

duals in less privileged positions.

There are two fundamental changes in the decision

environment. The changing society deprives the indivi-

dual of many energy-saving habits,24 and, at the same

time, there is a systematic increase in the number of

situations where he is explicitly expected to make

choices. In an economic perspective, both these devel-

opments suggest that the individual will feel compelled

to make certain calculated decisionsFthe alternative

prospect is often to suffer a reduction in utility. The

decision costs will be more of a burden on those with

fewer resources. Furthermore, the well off will be better

equipped to deal with this situationFbecause they rely

more on choice in daily life, they have lower decision

costs.

All things considered, it is therefore likely that in the

extensively individualized society, the odds for well-

being will be higher for those relatively well-off

individuals who are better adjusted to the strategy of

calculated choice, while the disadvantaged in society

experience that they are made worse off in utility terms.

The need to make decisions could also be seen as

stressful, giving rise to negative consequences for

health.25 Hence, there are several reasons why the

contemporary emphasis on individual choice could be

an important mechanism underlying the persistence of

social inequalities in health.

Concluding remarks

In this article, the nature of the decision process in

health-related behaviour was explored by using the

categories of habit and choice as a focus for the analysis.

It evolved around the finding of a social pattern in

relation to the habit–choice dichotomy in its various

24For example the increase in female labour market

participation has made the preparation of certain kinds of

food in the household impractical so that people are induced to

give up many of their habits-as-preferences.25One could also say that the emergence of a society where

individuals are systematically compelled to make decisions in

terms of choice implies a greater drain on emotional energy in

those groups for whom choice is not an embodied strategy. Cf.

Williams (1998) on the notion of emotional energy (capital) and

its theoretical importance as a potential link between social

structure and health.

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465462

dimensions. Approaching the same set of data from

different scientific view points and combining theoretical

perspectives within sociology and economics could be

seen as a particular version of the classical principle of

triangulation in qualitative research (Denzin, 1978).

Hence the confidence in the validity of our conclusions is

strengthened by the confluence of the implications of the

two approaches.26 We would also argue that many of

the results are due to the dialogue between two scientific

paradigms.

The essence of the common conclusions is the finding

that people in lower social positions are more inclined to

rely on habits and are accordingly less likely to change

their behaviour. These social differences are reinforced

as not only the disposition to maintain habits but also

the tendency to apprehend the habitual as something

good seem to be strengthened as we move down the

social hierarchy. These attitudes should, however, not

necessarily be seen as a truly independent factor. It

could rather be a manifestation of the partly subcon-

scious reliance on energy-saving habits or more speci-

fically of the individual’s habitus.

Finally, the most obvious aspect was the way in which

the habitual and the preferred were intertwined. There

was a clear tendency to account for one’s pattern of

behaviour by moving in circles from preferences to

habits and back to preferences again. This provides yet

another reason to expect social differences in behaviour.

The notion of a transitional period of disutility being

more of a burden for the less privileged is something

upon which both sociology and economics can agree.

There is also common ground regarding the perception

of new inequality-producing mechanisms engendered by

the process of individualization.

For policy purposes, the habit–choice dichotomy

helps explain why it is that health promotionFin

particular through information campaignsFtends to

increase rather than reduce social differences in health-

related behaviour. It can also help us understand the

consternation of health professionalsFbiased by the

middle-class outlookFregarding the relative disinclina-

tion of those in lower social positions to change

behavioural patterns.

We have focused on habits in the sense of repetitive,

non-reflective behaviour. Habitual behaviour is also

often associated with addiction. Our interviews covered

a broad spectrum of health-related behaviour, and

consequently provide little empirical basis for an

analysis of the specific relationship between habits and

addiction. However, our analysis suggests an interesting

hypothesis regarding social differences in addictive

behaviour. We noted that those in higher social

positions tended to take a disparaging view of sub-

ordinating one’s behaviour to habit. It seems likely that

this tendency functions as a restraint on the consump-

tion of potentially addictive goods, since the individual

would reasonably expect such consumption to be

relatively likely to turn into a habit. (Obviously,

however, there are many other factors underlying

observed differences in addictive behaviour, including

the previously mentioned importance of time prefer-

ences.) At the same time, from the macro viewpoint, it is

rather the institutionalized compulsion to choose that

bears an intriguing relationship to addiction. The

dominant notion that individuals have chosen their

lifestyles and consequently are responsible for their risky

behaviour naturally implies a declining tendency to see

people as victims of social conditions. It is a logical

consequence of this structurally conditioned process of

individualization that even drug addiction now tends to

be conceived as an expression of the individual’s rational

choice (Lindbladh, Lyttkens, Hanson, & .OOstergren,

1998).

A few concluding comments on the scientific dialogue

and the consequences for the two paradigms are

appropriate. As noted before, the sociologist’s focus

on decision making was initially inspired by economic

theory. The recognition of the socially polarized

categories of decision could in consequence indirectly

be assigned to this influence. It seems also obvious that

reflecting on economic theories of human behaviour

within the context of sociology has left concrete marks

on the sociological interpretation. The definition of

habits as rational decision rules with reference to their

lower decision costs (as compared to choice) could be

seen as one way to make the habitus mechanism

concrete. Accordingly this low-energy consumption

could be one way of explaining why people normally

feel at ease as long as there is an agreement between their

habitus and the everyday situations and demands with

which they are confronted.

With respect to economic research, our results suggest

that habits are very important at the micro-level as a

way to save on resources. It would seem that in many

contexts the economic model of individual behaviour

should be extended to take account of this fact

(Hodgson, 1997, 1998). Furthermore, it was noted that

the issue of social distinctions is not the normal focus for

an economist. This focus on social differences in

behaviour and attitudes towards habits has led to the

tentative hypothesis that the usual economic rational-

26A multi-theoretical approach does not necessarily eliminate

theoretical bias. It leads, however, to a more comprehensive

picture and entails an element of internal comparisons between

different explanatory perspectives that would reasonably

promote a critical assessment of interpretations and conclusions

(Flick, 1992). It is also worth noting that our model seems to

explain many other observations, such as the fact that

individuals in low social positions are much less prone to take

advantage of the possibility to change to more favourable bank

loans (SIFO, 2000).

E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 463

actor model is more likely to be applicable to high-

income people, whereas other models of behaviour

might be more useful with respect to the less well off.

Here the economics of satisficing behaviour, the old

institutional economics, or sociology, may provide a

useful source of inspiration.27 Future empirical work in

this direction might consequently lend support to

Bourdieu: ‘‘Economic theory which acknowledges only

the rational ‘responses’ of an indeterminate, inter-

changeable agent to ‘potential opportunities’ [y]

conceals the fact that the ‘rational’ habitus which is the

precondition for appropriate economic behaviour is the

product of a particular economic condition, the one

defined by possession of the economic and cultural

capital required in order to seize the ‘potential oppor-

tunities’ theoretically available to all.’’28

Acknowledgements

Financial support from the Swedish Council for

Planning and Co-ordination of Research, the Swedish

Council for Social Research, the Swedish Medical

Research Council (grant no. 27P-10737), and Axel and

Margaret Ax:son Johnsons foundation is gratefully

acknowledged. The authors have benefited from helpful

comments from John Cairns and the other participants

at the 19th Arne Ryde Symposium on Individual

Decisions for Health, Lund, Sweden, August 1999, and

from two anonymous referees.

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