The Nazi Antismoking Legacy 2

If Robert Proctor was prepared to dig into the murky history of Nazi antismoking science, Professor George Davey Smith seems to have been equally vocal in drawing attention to it, particularly when any mention of that history had been omitted by people who should have known better – such as Richard Peto, the long time assistant of Richard Doll. In 1995 he wrote to the editor of the BMJ to say:

EDITOR,—Richard Peto discusses the failure of public health with regard to smoking over the past 40 years,1 but his account could have extended back further. He considers that the Medical Research Council was, in 1957, “the first national institution in the world to accept formally the evidence that tobacco is a major cause of death.” The formal recognition of this fact, however, was explicitly made by many important national institutions in Nazi Germany. The Public Health Office and the German Medical Association, both under the leadership of Dr Gerhard Wagner, repeatedly issued precise pronouncements regarding the dire health consequences of smoking. By 1939 Wagner’s successor, Dr Leonardo Conti, had established the Reich Bureau Against the Dangers of Alcohol and Tobacco.2 The Reich Health Office also made numerous statements, which its president, Hans Reiter, reiterated at his inaugural address at the opening of the “first scientific institute for the struggle against the dangers of tobacco” at the University of Jena in 1942.3 The German Labour Front, under the leadership of Robert Ley, ran many campaigns highlighting the damaging effects of tobacco on health. Like Adolf Hitler, Reiter, Ley, Wagner, and Conti were, publicly at least, vehemently against smoking.2 4 5

Recognition of the damaging effects of smoking on health led to much antismoking legislation6; this included legislation banning smoking in public places by those under 18 and prohibiting both tobacco advertising and smoking in public buildings and on public transport. Pregnant women and those deemed to be sick because of smoking had their tobacco rations withdrawn, and there was serious discussion regarding whether those sick with illness caused by smoking should receive medical care equal to that given to patients whose illnesses were not considered to be self inflicted.5

Ten years later, he was on the blower again, this time to the WHO, to correct some assertions made by Michael J. Thun. In his letter he provides a potted history of German antismoking research:

Editor – In his commentary on early reports on smoking and lung cancer, Michael J. Thun ignores the actual first reports and concentrates on the series of case-control studies published in 1950, first in the United States and then in the United Kingdom (1). He also claims (as others have done) that in the pre-1950 era the most popular hypothesis was that “lung cancer mortality … was more likely to have resulted from the widespread tarring of roads and exhaust from motor vehicles than from cigarette smoking”. Could he please produce contemporary – i.e. pre-1950 – references on this hypothesis that match the veritable mountain of publications from pre-1950 implicating cigarette smoking (2), in particular, formal analytical studies of road tarring and motor exhaust similar to the many analytical studies of smoking and lung cancer?

Of course, as is now well known (3, 4, 5–10), extensive research on smoking and lung cancer appeared before 1950, much – but not all – of it from Weimar and then Nazi Germany. In 1928 Schönherr from Chemnitz drew attention to the high rates of smoking in a series of lung cancer patients (11). He explicitly studied where the lung cancer cases lived and reported they were not closer to roads than expected (tar and exhaust already being an unsupported hypothesis) and suggested that lung cancer in non-smoking wives of smokers was caused by passive smoke inhalation. In his comprehensive review of smoking and lung cancer in 1929 (reviews were already being written 20 years before the 1950 “discovery”) the influential actuary Frederich Hoffman wrote: “Unfortunately, German statistical discussions are invariably confusing and complicated by the omission of proper headings to statistical tables, which makes a full use of the elaborate investigation by Schönherr exceptionally difficult. Exceedingly rigorous reading is required to draw the best results from the mass of evidence presented. But every aspect of the problem is considered by this author, whose observations are deserving of being completely translated into English” (12). In a review published two years later, Hoffman considered that “smoking habits unquestionably increase the liability to cancer of the mouth, the throat, the oesophagus, the larynx and the lungs” (13).

In 1935, Fritz Lickint published an elegant synthetic review that considered time trends in lung cancer and cigarette smoking, ecological associations between smoking and lung cancer, autopsy series, experimental animal studies and clinical reports, which left him in no doubt that smoking was a cause of lung cancer (14). He had entitled a 1929 paper “Tobacco and tobacco smoke as etiological factors for carcinoma” (15); he simply did not think further studies were needed – what was required was to prevent smoking. His extraordinary 800-page work in 1939 (16) summarized all that was currently known from scientific research on the health consequences of smoking.

In 1939, a study of smoking habits of lung cancer cases compared with those of an ill-defined control group carried out by Franz Müller appeared in the Zeitschrift für Krebsforschung (17), a leading international cancer journal of its time (a time when many of the major science journals were in German). Four years later a considerably more sophisticated study by Schairer & Schöniger appeared in the same journal (18); an English translation is now readily accessible (19). This study involved a population and hospital control group (findings were similar in both), analysed the potential effect of people with illnesses quitting smoking, and tabulated results of their study together with previous data to show consistency (a formal statistical meta-analysis was not, unsurprisingly, performed. The odds ratios that can now be calculated from these early studies are very similar to those of the later studies published in the 1950s, and for the Schairer & Schöniger study alone statistical evidence for an association can be shown to be strong (P < 0.0000001).

The study by Schairer & Schöniger was carried out under the auspices of the Institute for the Struggle Against the Dangers of Tobacco based in Jena and supported, in part, by Adolf Hitler’s personal funds. The history of anti-smoking activity in Nazi Germany and its links to the practice and ideology of the ruling party have been discussed in detail elsewhere (3, 5, 6), but there was no simple connection between science and ideology. For example, Fritz Lickint – the most scholarly, best informed and active scientist in this field during the Nazi period – had been a supporter of the Social Democrats and, as one of us (GDS) discovered on a visit to the archives of the Institute in 1994, was subject to an SS investigation because of his suspect (anti-Nazi) politics and was denied employment at the Institute because of this.

It would appear that antismoking professionals are rather divided about how to handle the Nazi antismoking research. Some of them – like Richard Peto and Michael Thun – would seem to prefer that a veil be quietly drawn over it all, and 1950 be made the Year Zero of antismoking science, when 3 papers were published linking smoking and lung cancer in Britain and the USA. Others – like Robert Proctor and George Davey Smith – appear to want let it all hang out, and to re-instate the Nazi science as an example of good science carried out under adverse circumstances.

The understandable concern that acknowledging the roots of scientific investigation of the links between smoking and lung cancer may discredit anti-tobacco activity today is neither congruent with the multifaceted (and in no way simply “Nazi”) history of such science or with a true account of the complex development of scientific ideas.

Multifaceted indeed. I often wonder how ordinary people would react to learning that, far from the link of smoking with tobacco having first been made in 1950 by Doll and Hill in Britain, and Wynder and Graham in America, Nazi scientists (some of them personally funded by Adolf Hitler) had made the link 20 years earlier. I also wonder how they would respond to learning that the Nazi regime had run an anti-tobacco campaign that strangely prefigures the modern global war on tobacco.

Perhaps, as they shivered outside their pubs, they would tell each other that it was a good example of the “multifaceted history” of such science, and of the “complex development” of scientific ideas.

In fact I’m sure they would — if anyone ever told them about it.

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21 Responses to The Nazi Antismoking Legacy 2

  1. Frank Davis says:

    As an appendix, I might add these remarks by Richard Doll:

    Was yours the first epidemiological study on lung cancer?

    RICHARD DOLL There were a few others, but we were the first to have sufficient confidence in our findings to state that “We conclude that smoking is a cause and an important cause of the disease.” A couple of very primitive studies had been carried out in Germany, but they were very flawed. For example, one used the average age of lung cancer patients as a basis for selecting control patients – so if the average age of the lung cancer patients was 54, they interviewed a lot of people aged 54. You really need to have the separate experiences of a 70-year-old and a 30-year old, you can’t assume that the experience of a 54-year-old is representative. Then there was a US study that came out about the same time as ours and had similar findings, but because they had used less rigorous techniques, they were more cautious about drawing conclusions from their data, and merely concluded that there was an association they’d found which might imply causality.

    This is rather puzzling. Doll must have been aware that there were a lot more than just a couple of German studies. There had been whole books written on the subject.

    It sounds like he’s simply talking up his own role. Yes, the Germans had done a “couple” of “primitive” studies. And some American had done a study using “less rigorous” techniques. So, y’see, it was Me who showed that smoking caused lung cancer. Oh yes.

    Presumably Doll is talking about his “more rigorous” London Hospitals study, in which 98% of the patients in both the study and control groups were smokers.

  2. Junican says:

    And so the plot (and I mean ‘plot’) thickens…..

    I was only thinking today about a little peculiarity. The peculiarity is that, up until a few years ago, ‘the big C’ was not discussed – not in conversation, not in the MSM. Was the sudden ending of the ‘verboten’ as regards talking about cancer the trigger for the anti-smoking campaign, or was it the other way round?

    Interesting, don’t you think?

  3. smokervoter says:

    Without clicking on the Proctor Nicotine Nazi link (it’s a PDF and I generally balk at them), just from prior memory I recall that first Proctor defends Nazi-like public health efforts as worthwhile as long as the result is cleaner air. Then Glantz chimes in by accusing Big Tobacco of creating a straw man with the use of the term Nicotine Nazi or some such. And there was a map of a Jewish ghetto published in a magazine to point out the Nazi parallel to smokers’ segregation if I recall correctly. The truth hurts, eh boys?

    I’d like to see that sort of pushback make a comeback to tell you the truth, except there are no magazines anymore. It’s probably illegal under terms of the MSA and the FCTC, thus making us all the more aware of tobacco control’s ‘excusable’ totalitarian bent.

    I’m not sure that some of the young people I’ve seen leaving web comments would care about the Nazi era similarities anyway. It’s too long ago for them and besides, with the steady diet of MSM/government antismoking swill they’ve been fed, I think some of them would make good Brown Shirts.

    On the other hand a lot of the kids like Ron Paul, so there is some hope.

  4. JJ says:

    Frank – sorry to be offi topic, but can you tell me where I can download that diagram of creating an HTML link? Thanks. You had this on your previous site.

  5. Gary K. says:

    This is all well and good; but, what if the antis actually feel(in their hearts) that there was much to be admired and copied in the Nazi affair.

    They may protest at the comparison; but, they are quite happy to be similiar in many ways.

    I would suggest that the antis are more like the American ‘Klu Klux Klan'(KKK) in their bigoted,biased dehumanization and denormalization of people.

    There are a lot of similarities!

    • Frank Davis says:

      I think they do admire the Nazis in lots of ways. Maybe they just thought the Nazis went too far in some respects.

      I can’t really comment on the KKK because I don’t know too much about them.

  6. Rose says:

    Odd things seem to be happening today.

    Under the title “Smoking ads are more about class than compassion” The writer, talking about graphic pictures on cigarette packets purporting to be images of smoking related death and disease, stated that “They are disrespectful, de-humanising and abusive of law-abiding citizens.”

    It shows you how far it’s gone that I should be surprised to see such an obvious statement in a newspaper.
    But the Financial Times asks me very nicely not copy the article and post it round the internet, so I won’t, it’s top of the page on google.

    Found on The Smokers Club, an article from Natural News.

    FDA unfairly maligns tobacco plant with graphic new cigarette warning labels

    “But there’s something missing in this whole debate that neither the FDA nor health authorities dare talk about: there is a huge difference between smoking chemically-laced “processed” cigarettes versus natural tobacco leaves.”

    Tobacco is an amazing, miraculous plant with a multitude of uses, while cigarettes are highly processed, chemically-laced products made with filler and synthetic ingredients that no one in their right mind would smoke if they had any sense. The problem, though, is that no one in the FDA — nor the entire western medical profession, it seems — makes any distinction between natural tobacco and highly processed, chemically-laced cigarettes. To hear them say it, all cigarettes are equally bad for you, regardless of what’s in them (or not).”

    “Blaming tobacco for the health ills of cigarettes is like blaming corn plants for the increased risk of cancer that comes from eating corn dogs. (The cancer increase actually comes from the presence of sodium nitrite in the processed meat, in case you were wondering.)

    The brainwashing of the population on this issue of tobacco has been so successful that many people reading this article with react emotionally against the words presented here, in a knee-jerk reaction, insisting that tobacco (the plant) MUST be bad for your health because we’ve all been taught that for as long as we can remember! “Tobacco” is something we’ve been emotionally conditioned to react to without thinking… almost as if “tobacco = evil.”

    The writer is at great pains to disassociate himself from smoking and clearly believes in the nicotine addiction theory, he also appears to have no idea of the nicotine content of common vegetables – but what a wonderful change.

    • Gary K. says:

      ” the nicotine content of common vegetables.”

      And fruits, tomatoes contain nicotine; but, tomatoes are a fruit.
      Knowledge vs Wisdom(common sense)

      Knowledge is knowing that tomatoes are fruit and Wisdom is knowing not to put them in fruit salad.

      Antis have some Knowledge; but, not a lot of Wisdom!!! :)

    • Briar Tuck says:

      I completely agree – it is a very encouraging change. His reasoning is sound, and aligns with what Dave Hitt and others have been saying for years. The effort expended in the article to distance the author from ‘encouraging others to smoke’ or explicitly finding favour with ‘smoking anything’ does rather smack of a kind of literary contortionism which may (typically, alas) have been required in order to get the article published at all, but his key points are nevertheless sound.

      Sometimes, in this whole debate, it seems to me that positions are adopted which owe their adoption to a reaction to the perceived views of the other side. For (crude, for illustration) example: It is often assumed that an anti-smoking Guardianista will vigorously support all smoking bans, vegetarianism, whole foods, knit-your-own sandals, and so on (you know the type). He/she will have an image in their head of their opponents; to them, they will be overweight male ‘little Englanders’ who like to eat processed junk food and watch a lot of Sky Sports (you will know that type, too).

      Because the antis’ output makes these assumptions, a polarising of views happens, and things get very confusing. For our part, it is then very hard to see our opponents in any other terms than variations on the Guardianista cliché above.

      I, on the other hand, would postulate that your typical anti-smoker is, at least subconsciously, very much in favour of government interference in as much as possible, and would therefore, in fact, want everyone to shop at Tesco and eat as much highly-processed, industrial junk as possible, since this would make it easier, through industry regulation or directives, for government (national or supra-national) to control individuals’ chemical intake – and therefore their day-to-day moods, preferences and sensibilities.

      All the face-to-face arguments I’ve ever had (and there have been many) with antismokers have revealed this, eventually. I want to retain the availability of choice – I personally choose (with food, tobacco, booze, you name it) always to buy the product which has had the minimum done to it. In the case of consumables, this invariably means that you get more of what you want for your money. With other goods, less tech often means longer product life…

      I bought a pair of sandals last week. They’re basic leather flip-flops (sole, and uppers). They will be less comfortable at first, because one of the properties of leather is that it’s malleable over time, and some of the things that make it so include the application of grease from one’s own skin, together with raising its temperature close to blood heat, and applying mechanical stress; all these things can be accomplished by simply wearing them. Over a short time, leather sandals then form themselves to your feet, to the extent that quite quickly, you hardly even know you’re wearing them. Later on (much), since this is a low-tech product, they can be easily repaired or even remade completely.

      Compare and contrast this low-tech, comfortable and practical product with its competition: similar (in principle) footwear, but with plastic upper strapping, a bungy foam footpad, and a blown synthetic chemical foam sole. You try them on in the shop, and they feel soft, spongey and seductive, so you buy them. When your feet get hot, they get sticky, and the plastic uppers don’t absorb this, so forming a magnet for dusty and gritty particles to adhere between your foot and the shoe (ouch). Under your foot, the ‘mattress’ foot pad gets sweaty (as the air can’t get in) and any indentations fill in with a nice mix of sweat and old skin cells (mmm). After a year or so, the blow-moulded outer sole has leached most of its plasticising chemicals into the atmosphere, and therefore becomes brittle when flexed (ie, when you walk), with the result that it splits laterally. This happens irrespective of whether you’ve worn them every day for a year, or just left them in a cupboard – it’s a function of time, not use [consumer rage about this phenomenon here: ]. Complete pair of sandals (which cost more than the leather ones, don’t forget) are now a write off – they can’t be repaired, because the manufacturing process doesn’t allow this. So like a good little unquestioning, approved, correct-thinking consumer, off you go to buy a new pair, and start the whole sorry process off all over again.

      My leather ones, also, were to replace my last pair. But I bought those latter in 1976, and they’d had three new sets of outer soles. That, my friends, is real product integrity, produced by a single craftsman with a sewing machine and some knives, versus synthetic crap blow-moulded by Chinese seven-year-olds.

      Can we not perhaps, apply the same principles to both food and tobacco? Taking the basic issues raised by the admittedly fatuous (but true) example above, why does tobacco have to be made into mass-produced, mass-marketed product, if not for the sake of control? Should we not have a situation where retail tobacconists make up their own product (“Tin of fifty No. 3 Balkan, Sir? – I thought I’d sold all of this week’s batch, but I think there’s one left here”) for stock or to order?

      Should we not be demanding product provenance? – I want a harvesting date, country and region of origin and a proper AOC-type stamp on every tobacco product I buy, and I want it to contain unadulterated tobacco, with (if required) unadulterated paper. I don’t want accelerants, I don’t want flavourings (flavour comes from the tobacco used), I don’t want artificial preservatives (waxed paper wrapping used to be fine for yoghurt in most of Eastern Europe – it would certainly work to preserve tobacco). There is an army of small shopkeepers ready to participate in tobacco’s rebirth as a gourmet product, in much the same way as cheese in recent years, in spite of cholesterol and other ‘health’ (ie, control) scares. We just need to be fussy, nit-picking, demanding consumers. We also need to be appreciative when something gets done right.

      That should be the vision (or part of it, at least). In that context, the Natural News article does no harm at all. Ho Hum.

      • Frank Davis says:

        I think there are several stereotypes of antismokers, none of which are probably wholly accurate. For myself, I find myself making a distinction between, as it were, the professionals and the amateurs. The amateurs are the ones that infest the comments in the Guardian, and say that smoking stinks, and wish death on smokers, and are otherwise obnoxious, and who usually know next to nothing about smoking and tobacco except what they’ve seen on TV. The professionals (almost) never come out such sentiments, and know a great deal more, and spend their days digging up evidence, lobbying governments for legislation, and so on. Of the two, the former are just a nuisance, and the latter are by far the most dangerous.

        I should add that, until not very long ago, I was myself something of a Guardianista. I used to read the paper for many years. I was at home with its ‘enlightened’ views. And I regarded myself as left wing in a free-floating, non-ideological, Guardianista way. I even have some sandals somewhere. It’s been the smoking ban which has catapulted me out of those slumbers, to find myself paying far more attention to right wing thinking than I ever used to.

        I think that the antismoking ideologues do indeed want government control of lifestyles. I think they have a model of society which is one of top-down control, and that is what smoking bans are all about. But I don’t think that your average Guardianista carries around that sort of model of society. They aren’t ideologues. They aren’t Marxists. They aren’t fundamentalists. Well, at least not in my experience. They are instead prone to enthusiasm about a variety of Good Causes. They are, in short, quite different creatures than the antismoking ideologues with which they so often make common cause.

  7. Junican says:

    It bothers me that ‘short term’ politicians, without knowing what they are doing, can pass laws which are created by unidentifiable and unaccountable ‘aristocrats’.
    Isn’t that an odd use of the word ‘aristocrates’? But is it not true that there are groups of people who are above politics,but who use politics to persue their agenda? These people are the new ‘aristocrats’.

    The new ‘aristocrats’ are ASH, etc – and MPs are their useful idiots.

  8. Hopefully it will be useful new elected politicians that repeal what these useless politicians did!

  9. churchmouse says:

    Frank — For info down the side, I just publish a post and put it under the sidebar category where I want it to appear. I published the two posts initially, then went to Links (admin page), copied the title and the link. So, while the posts will appear on your home page for a while, they will end up being immediately — and perpetually — visible in your sidebar.

  10. The creation of top quality cigars is really a hundred years long traditions across the South America. Although the most famous suppliers associated with matches are situated upon Cuba the technologies was distributed within the entire place of the region because the religious exercise associated with nearby religions

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