Smoking and health promotion in Nazi Germany

[Trends in smoking among adults in Germany : Evidence from seven population-based health surveys from 1991-2015]

BACKGROUND

Despite decreasing smoking prevalence, tobacco use remains a key public health problem in Germany. For planning, managing, and evaluating tobacco control measures, regular data collection on smoking behavior in the population is essential. The aim of this article is to present trends in adult tobacco use since the early 1990s based on data from the health monitoring of the Robert Koch-Institute (RKI).

METHODS

Analyses are based on data from 106,158 individuals aged 18 to 79 years, who participated in seven RKI health surveys from 1991-2015. Trends in tobacco consumption were analyzed using different indicators of smoking behavior, stratified by age, cohort, and gender.

RESULTS

An overall falling smoking prevalence can be attributed primarily to a significant decline in the younger age groups since the early 2000s. Trend analysis by cohort reveals a declining prevalence for almost all cohorts over time from 1991-2015. Historically there has been is a sharp increase in the prevalence of women who have ever smoked between the 1930-1934 and 1950-1959 cohorts. The proportion of men who have ever smoked slightly decreased between the 1930-1934 and 1980-1984 cohorts.

DISCUSSION

The shown overall decline happened concurrently with various tobacco prevention measures implemented during this period in Germany. If present trends related to continuous high smoking rates are sustained, it can be assumed that the tobacco consumption of the population will remain the source of adverse health outcomes. Accordingly, tobacco prevention measures and the promotion of smoking cessation in all age groups should be a public health priority.

Inhaling Democracy: Cigarette Advertising and Health Education in Post-war West Germany, 1950s-1975

In the late 1960s and early 1970s, the West German government was faced with the challenge of addressing a damaging health behaviour, smoking, in the context of an emerging late modern democracy, when the precedent for addressing that behaviour was set in the Nazi past. This paper details the two-pronged approach which the government took: seeking restrictions on cigarette advertising, whilst educating young people to adopt positive health behaviours in the face of pressure to smoke. This approach can be understood in the social and economic context of the time: an economic commitment to the social market economy worked against restrictions on the sale of cigarettes; whilst concerns about past authoritarian structures prompted the health authorities to seek novel ways of addressing smoking, emphasising choice. In a nuanced way, post-war anti-smoking strategies were a response to West Germany's National Socialist past, but more importantly, a signal of an increasingly international outlook.

Trends in the lung cancer incidence and mortality in the Slovak and Czech Republics in the contexts of an international comparison

INTRODUCTION

Lung cancer represents the most frequent cause of cancer-related deaths in the industrialized countries. The aim of this study was to analyze the lung cancer incidence and mortality and the possible reasons for any differences discovered in two neighboring Central European countries-the Slovak Republic.

METHODS

We used linear regression model when analyzing incidence and mortality; the trends are presented with corresponding 95% confidence intervals (CI) and p-value with null hypothesis being constant with time.

RESULTS

Statistically significant increase of age-standardized incidence (0.707/100,000/year, 95% CI 0.107-1.307, p = 0,025) and mortality (1.339/100,000/year, 95% CI 1.050-1.629, p < 0.0001) of the lung cancer was revealed in males in the Slovak Republic (1980-1991). On the contrary, values of both indicators were stabilized in the Czech Republic. Since year 1991-2005 a statistically highly significant decrease of both incidence and mortality values was observed in males, which was greater in the Slovak Republic. Peak of the curve was not reached in women population, while incidence and mortality values have significantly continuous growth in both countries.

CONCLUSIONS

According to the lung cancer incidence and mortality trends in both countries (in correlation with smoking prevalence) we consider the support of efforts to change the attitude towards smoking predominantly in women and younger generation to be the most accurate action to reduce these trends.

Tobacco policies in Nazi Germany: not as simple as it seems

OBJECTIVE

Reluctance to develop effective tobacco control measures in Germany has been attributed to the anti-smoking stance taken by the Nazis, which has encouraged pro-smoking groups to equate tobacco control advocacy with totalitarianism. This paper reassesses the scale and nature of tobacco control in Germany during the Third Reich.

STUDY DESIGN AND METHODS

Analysis of documents and reports about the situation in Germany in the 1930s and 1940s supplemented by a review of Reich legal ordinances, party newspapers, health behaviour guidelines issued by Nazi party organizations, and interviews with expert informants.

RESULTS

While there was considerable opposition to smoking in Nazi Germany, there was no consistent Nazi policy to combat smoking, and what did exist built on pre-existing policies. Although extreme measures were taken in isolated localities or by overzealous party members, there was a marked ambivalence to tobacco control at the highest levels. Many policies were contradictory; measures were often not enforced, and cigarettes were actively distributed to 'deserving' groups.

CONCLUSION

Policies on tobacco in Nazi Germany are much more complex than is often represented by those who invoke them to condemn those seeking to reduce the burden of disease caused by smoking.

THE POLICY RESPONSE TO THE SMOKING AND LUNG CANCER CONNECTION IN THE 1950s AND 1960s

A key current concern is how scientific knowledge may inform policy in relation to major environmental and health concerns. There are distinct schools of analysis about this relationship between science and policy. They stress rational relationships; denial and delay; or the role of networks. History is important in modifying such perspectives: smoking policy in the 1950s and 1960s is the case study here. The initial response in the 1950s to the link between smoking and lung cancer was in part conditioned by the role of the tobacco industry and the financial importance of tobacco: the British tobacco industry had closer relationships with government than the American one, and did not rely on public relations. Public health interests worked with the industry. But politicians were concerned also about the fluidity of the epidemiological evidence; the dangers of stirring up further pressure over air pollution; the financial and ideological implications of health education and its location; and the electoral dangers of intervening in a popular mass habit. In the 1960s the British and American medical reports stimulated the growth of a public health 'policy community'. The initial political considerations began to weaken and these years marked the beginning of a new style of public health.

[Historic landmarks in the study of lung cancer]

This study reviews the milestones which have been reached in the study of lung cancer, from its first early descriptions up until the end of the twentieth century. The study accompanies the birth of this new clinical entity, underlining the difficulties inherent in its diagnosis, its ever-growing increase and traces the growth of its aetiological factors, placing particular emphasis on smoking. In tandem with this, the study delves into the clinical aspects, along with new discoveries in imaging techniques and endoscopic and bioscopic techniques. It also looks at the histopathological classifications of bronchopulmonary tumours and the various staging systems which have been used over the course of time as well as the importance of mapping the disease and the different treatment weapons which have successively become available in the fight against it. The study also takes a look at the scales used in evaluating patients' physiological condition, the criteria used in evaluating response to oncostatic treatment and the role some international and national scientific societies and medical associations have played in adding to the increasing medical knowledge of lung cancer. The study clearly shows to whom we are indebted for each advance. This is a fascinating sweep of history - as is the story of all medical progress - and one we feel is important to understand, in order for us to see more clearly where we are now.

Health lifestyles and political ideology in Belarus, Russia, and Ukraine

This paper examines the association of political ideology with health lifestyle practices and self-rated health in Belarus, Russia, and Ukraine. The political trajectory of post-Soviet societies has taken two divergent paths, either toward democracy or autocracy. The health trajectory has followed the same pattern with the more autocratic states continuing to experience a mortality crisis, while those former socialist countries that have embraced democracy and moved closer to the West have escaped this crisis. This paper investigates whether political ideology in three post-Soviet countries that are firmly (Belarus), increasingly (Russia), or recently (Ukraine) autocratic is related to health lifestyles and health self-ratings. Data were collected by face-to-face interviews (N = 8406) with a representative national sample of the adult population. The results show that respondents who are against restoring communism have healthier lifestyles and rate their health better than respondents who wish to see communism return.

Lifestyle, health, and health promotion in Nazi Germany

Several health related behaviours came under scrutiny in the 1930s and '40s in Germany, but did the associated campaigns achieve any benefits?

Tobacco and the global lung cancer epidemic

Tobacco is the world's single most avoidable cause of death. The World Health Organization has calculated that the 5.6 trillion cigarettes smoked per year at the close of the twentieth century will cause nearly 10 million fatalities per year by 2030. Lung cancer is the most common tobacco-related cause of cancer mortality, with one case being produced for every 3 million cigarettes smoked. How was the global lung cancer epidemic recognized, and what can we expect in the future?

Smoking and death. Public health measures were taken more than 40 years ago

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