Nazi Germany started a strong anti-tobacco movement^[1] and led the first public anti-smoking campaign in modern history.^[2] In 1940, German scientists found a link between smoking tobacco, and lung cancer.^[3]

Anti-tobacco movements grew in many countries from the beginning of the 20th century. But all these had little success. The only exception was Germany where it was supported by the government after the Nazis came to power.^[4] It was the most powerful anti-smoking movement in the world in the 1930s and early 1940s.^[5] The Nazi leaders opposed smoking and some of them openly said what is wrong with tobacco consumption.^[5] Research on smoking and its effects on health got better under Nazi rule^[6] and was the most important of its type at that time.^[7] Adolf Hitler did not like tobacco^[8] and the Nazi reproductive policies were among the causes due to which the Nazis started their campaign against smoking. This campaign was linked with antisemitism and racism.^[9]

The Nazi anti-tobacco campaign used many methods like restrictions on smoking in public spaces, limiting tobacco advertising, restrictions on tobacco rations for women, restrictions on restaurants and coffeehouses,^[5] promoting health education,^[10] banning smoking in trams, buses and city trains, limiting cigarette rations in the Wehrmacht, organizing medical lectures for soldiers and increasing the tobacco tax.^[5] The anti-tobacco movement did not have much effect in the early years of the Nazi rule. Tobacco use increased between 1933 and 1939.^[11] But smoking by military personnel declined from 1939 to 1945.^[12] This anti-smoking campaign was more powerful and serious than the anti-tobacco movement in Germany at the beginning of the 21st century.^[11]

Anti-tobacco thoughts existed in Germany in the early 1900s. People who disliked smoking formed the first anti-tobacco group in the country named the Deutscher Tabakgegnerverein zum Schutze der Nichtraucher (German Tobacco Opponents' Association for the Protection of Non-smokers). Established in 1904, this organization existed for a brief period only. The next anti-tobacco organization, the Bund Deutscher Tabakgegner (Federation of German Tobacco Opponents), was established in 1910 in Trautenau, Bohemia. Other anti-smoking organizations were established in 1912 in the cities of Hanover and Dresden. In 1920, a Bund Deutscher Tabakgegner in der Tschechoslowakei (Federation of German Tobacco Opponents in Czechoslovakia) was formed in Prague, after Czechoslovakia was separated from Austria at the end of World War I. A Bund Deutscher Tabakgegner in Deutschösterreich (Federation of German Tobacco Opponents in Austria) was established in Graz in 1920.^[13]

These groups published journals advocating nonsmoking. The first such German language journal was Der Tabakgegner (The Tobacco Opponent), published by the Bohemian organization between 1912 and 1932. The Deutsche Tabakgegner (German Tobacco Opponents) was published in Dresden from 1919 to 1935, and was the second journal on this issue.^[14] The anti-tobacco organizations were also against drinking of alcohol.^[15]

Adolf Hitler was a heavy smoker in his early life, smoking 25 to 40 cigarettes daily. He gave up when he realized it was a waste of money.^[8] In later years, Hitler viewed smoking as "decadent"^[12] (meaning that it was bad for his health) and "the wrath of the Red Man against the White Man, vengeance for having been given hard liquor".^[8] He was sad that "so many excellent men have been lost to tobacco poisoning".^[16] He was unhappy because both Eva Braun and Martin Bormann were smokers and was concerned over Hermann Göring's continued smoking in public places. He was angered when a statue of Göring showed a cigar in his mouth.^[8] Hitler is often considered to be the first national leader to advocate nonsmoking.^[17]

Hitler disapproved of the military personnel's freedom to smoke, and during World War II he said on March 2, 1942, "it was a mistake, traceable to the army leadership at the time, at the beginning of the war". He also said that it was "not correct to say that a soldier cannot live without smoking". He promised to end the use of tobacco in the military after the end of the war. Hitler personally encouraged close friends not to smoke and rewarded those who quit smoking. However, Hitler's dislike for tobacco was only one of several reasons behind the anti-smoking campaign.^[8]

The Nazi reproductive policies were an important factor behind their anti-tobacco campaign.^[9] Women who smoked were considered to be more likely to age prematurely, and lose physical attractiveness; they were viewed as unsuitable to be wives and mothers in a German family. Werner Huttig of the Nazi Party's Rassenpolitisches Amt (Office of Racial Politics) claimed smoking mothers' breast milk contained nicotine.^[18] Martin Staemmler, an important doctor during the Third Reich, said that smoking by pregnant women resulted in a higher rate of stillbirths and miscarriages. This was supported by the well-known female racial hygienist Agnes Bluhm, in her book published in 1936. The Nazi leadership was concerned about this because they wanted German women to give birth. An article published in a German gynecology journal in 1943 stated that women smoking three or more cigarettes per day were more likely to remain childless compared to nonsmoking women.^[19]

Research and studies on tobacco's effects on the population's health were more advanced in Germany than in any other nation by the time the Nazis came to power.^[5] The link between lung cancer and tobacco was first proved in Nazi Germany,^[16][20][21] contrary to the popular belief that American and British scientists first discovered it in the 1950s.^[16] The term "passive smoking" ("Passivrauchen") was coined in Nazi Germany.^[2] Research projects funded by the Nazis revealed many disastrous effects of smoking on health.^[22] Nazi Germany supported epidemiological research on the harmful effects of tobacco use.^[1] Hitler personally gave financial support to the Wissenschaftliches Institut zur Erforschung der Tabakgefahren (Scientific Institute for the Study of Tobacco Hazards) at the University of Jena, headed by Karl Astel.^[12][23] Established in 1941, it was the most significant anti-tobacco institute in Nazi Germany.^[23]

Franz H. Müller in 1939 and E. Schairer in 1943 first used case-control epidemiological methods to study lung cancer among smokers.^[12] In 1939, Müller published a study report in a reputed cancer journal in Germany claiming that prevalence of lung cancer was higher among smokers.^[1] Müller, described as the "forgotten father of experimental epidemiology",^[24] was a member of the National Socialist Motor Corps (NSKK) and the National Socialist German Workers’ Party (NSDAP). Müller's 1939 medical dissertation was the world's first controlled epidemiological study of the relationship between tobacco and lung cancer. Apart from mentioning the increasing incidents of lung cancer and many of the causes behind it such as dust, exhaust gas from cars, tuberculosis, X-ray and pollutants emitted from factories, Müller's paper pointed out that "the significance of tobacco smoke has been pushed more and more into the foreground".^[25]

Physicians in the Third Reich were aware that smoking is responsible for cardiac diseases, which were considered to be the most serious diseases resulting from smoking. The use of nicotine was sometimes considered to be responsible for increased reports of myocardial infarction in the country. In the later years of World War II, researchers considered nicotine a factor behind the coronary heart failures suffered by a significant number of military personnel in the Eastern Front. A pathologist of the Heer examined thirty-two young soldiers who had died from myocardial infarction at the front, and documented in a 1944 report that all of them were "enthusiastic smokers". He cited the opinion of pathologist Franz Buchner that cigarettes are "a coronary poison of the first order."^[18]

The Nazis used several public relations tactics to convince the general population of Germany not to smoke. Well-known health magazines like the Gesundes Volk (Healthy People),^[22] Volksgesundheit (People's Health) and Gesundes Leben (Healthy Life)^[26] published warnings about the health consequences of smoking^[22][26] and posters showing the harmful effects of tobacco were displayed. Anti-smoking messages were sent to the people in their workplaces,^[22] often with the help of the Hitler-Jugend (HJ) and the Bund Deutscher Mädel (BDM).^[9][22][26] The anti-smoking campaign undertaken by the Nazis also included health education.^[10][20][27] In June 1939, a Bureau against the Hazards of Alcohol and Tobacco was formed and the Reichsstelle für Rauschgiftbekämpfung (Bureau for the Struggle against Addictive Drugs) also helped in the anti-tobacco campaign. Articles advocating nonsmoking were published in the magazines Die Genussgifte (The Drugs for Enjoyment), Auf der Wacht (On the Guard) and Reine Luft (Clean Air).^[28] Out of these magazines, Reine Luft was the main journal of the Nazi anti-tobacco movement.^[5]

After recognizing the harmful effects of smoking on health, several items of anti-smoking legislation were enacted.^[29] The later 1930s increasingly saw anti-tobacco laws implemented by the Nazis. In 1938, the Luftwaffe and the Reichspost imposed a ban on smoking. Smoking was also banned not only in health care institutions but also in several public offices and in rest homes.^[5] Midwives were restricted from smoking while on duty. In 1939, the Nazi Party outlawed smoking in all of its offices' premises, and Heinrich Himmler, the then chief of the Schutzstaffel (SS), restricted police personnel and SS officers from smoking while they were on duty.^[30] Smoking was also outlawed in schools.^[22]

In 1941, tobacco smoking in trams was outlawed in sixty German cities.^[30] Smoking was also outlawed in bomb shelters; however, some shelters had separate rooms for smoking.^[5] Special care was taken to prevent women from smoking. The President of the Medical Association in Germany announced, "German women don't smoke".^[31] Pregnant women and women below the age of 25 and over the age of 55 were not given tobacco ration cards during World War II. Restrictions on selling tobacco products to women were imposed on the hospitality and food retailing industry.^[30] Anti-tobacco films aimed at women were publicly aired. Editorials discussing the issue of smoking and its effects were published in newspapers. Strict measures were taken in this regard and a district department of the National Socialist Factory Cell Organization (NSBO) announced that it would expel female members who smoked publicly.^[32] The next step in the anti-tobacco campaign came in July 1943, when public smoking for persons under the age of 18 was outlawed.^[9][26][30] In the next year, smoking in buses and city trains was made illegal,^[12] on the personal initiative of Hitler, who feared female ticket takers might be the victims of passive smoking.^[5]

Restrictions were imposed on the advertisement of tobacco products,^[33] enacted on December 7, 1941, and signed by Heinrich Hunke, the President of the Advertising Council. Advertisements trying to depict smoking as harmless or as an expression of masculinity were banned. Ridiculing anti-tobacco activists was also outlawed,^[34] as was the use of advertising posters along rail tracks, in rural regions, stadiums, and racing tracks. Advertising by loudspeakers and mail was also prohibited.^[35]

Restrictions on smoking were also introduced in the Wehrmacht. Cigarette rations in the military were limited to six per soldier per day. Extra cigarettes were often sold to the soldiers, especially when there was no military advance or retreat in the battleground, however, these were restricted to 50 for each person per month. Access to cigarettes was not allowed for the Wehrmacht's female auxiliary personnel. Medical lectures were arranged to persuade military personnel to quit smoking. An ordinance enacted on November 3, 1941, raised tobacco taxes by approximately 80–95% of the retail price. It would be the highest rise in tobacco taxes in Germany for more than 25 years after the collapse of the Nazi regime.^[5]

The early anti-smoking campaign was thought to be a failure, and from 1933 to 1937 there was a rapid increase in tobacco consumption in Germany.^[11] The rate of smoking in the nation increased faster even than in neighboring France, where the anti-tobacco movement was tiny and far less influential. Between 1932 and 1939, per capita cigarette consumption in Germany increased from 570 to 900 per year, while the corresponding numbers for France were from 570 to 630.^[5][36]

The cigarette manufacturing companies in Germany made several attempts to weaken the anti-tobacco campaign. They made new journals and tried to show the anti-tobacco movement as "fanatic" and "unscientific".^[5] The tobacco industry also tried to counter the government campaign to prevent women from smoking and used smoking models in their advertisements.^[31] Despite government regulations, many women in Germany regularly smoked, including the wives of many high-ranking Nazi officials. For instance, Magda Goebbels smoked even while she was interviewed by a journalist. Fashion illustrations displaying women with cigarettes were often published in prominent publications such as the Beyers Mode für Alle (Beyers Fashion For All). The cover of the popular song Lili Marleen featured singer Lale Andersen holding a cigarette.^[32]

The Nazis implemented more anti-tobacco policies at the end of the 1930s and by the early years of World War II, the rate of tobacco usage declined. As a result of the anti-tobacco measures implemented in the Wehrmacht,^[5] the total tobacco consumption by soldiers decreased between 1939 and 1945.^[12] According to a survey conducted in 1944, the number of smokers increased in the Wehrmacht, but average tobacco consumption per military personnel declined by 23.4% compared to the immediate pre-World War II years. The number of people who smoked 30 or more cigarettes per day declined from 4.4% to 0.3%.^[5]

The Nazi anti-tobacco policies were not exempt of contradictions. For example, the Volksgesundheit (People's Health) and Gesundheitspflicht (Duty to be Healthy) policies were enforced in parallel with the active distribution of cigarettes to people who the Nazis saw "deserving" groups (e.g. frontline soldiers, members of the Hitler Youth). "Undeserving" and stigmatized groups (Jews, war prisoners), however, were denied access to tobacco.^[37]

Apart from public health concerns, the Nazis were heavily influenced by ideology;^[22] specifically, the movement was influenced by concepts of racial hygiene and bodily purity.^[38] Nazi leaders believed that it was wrong for the master race to smoke^[22] and that tobacco consumption was equal to "racial degeneracy".^[39] The Nazis viewed tobacco as a "genetic poison".^[38] Racial hygienists opposed tobacco use, fearing that it would "corrupt" the "German germ plasm".^[40] Nazi anti-tobacco activists often tried to depict tobacco as a "vice" of the "degenerate" Africans.^[38]

The Nazis claimed that the Jews were responsible for introducing tobacco and its harmful effects. The Seventh-day Adventist Church in Germany announced that smoking was an unhealthy vice spread by the Jews.^[40] Johann von Leers, editor of the Nordische Welt (Nordic World), during the opening ceremony of the Wissenschaftliches Institut zur Erforschung der Tabakgefahren in 1941, proclaimed that "Jewish capitalism" was responsible for the spread of tobacco use across Europe. He said that the first tobacco on German soil was brought by the Jews and that they controlled the tobacco industry in Amsterdam, the principal European entry point of Nicotiana.^[41]

After the collapse of Nazi Germany at the end of World War II, American cigarette manufacturers quickly entered the German market. Illegal smuggling of tobacco became prevalent,^[42] and leaders of the Nazi anti-smoking campaign were silenced.^[6] In 1949, approximately 400  million cigarettes manufactured in the United States entered Germany illegally every month. In 1954, nearly two billion Swiss cigarettes were smuggled into Germany and Italy. As part of the Marshall Plan, the United States sent free tobacco to Germany; the amount of tobacco shipped into Germany in 1948 was 24,000 tons and was as high as 69,000  tons in 1949. The Federal government of the United States spent $70  million on this scheme, to the delight of cigarette manufacturing companies in the United States, who profited hugely.^[42] Per capita yearly cigarette consumption post-war Germany steadily rose from 460 in 1950 to 1,523 in 1963. The present-day anti-tobacco campaign in Germany has been unable to exceed the seriousness of the Nazi-era climax in the years 1939–41 and German tobacco health research at the end of the 20th century is described by Robert N. Proctor as "muted".^[11]

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