Public health measures were taken more than 40 years ago

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 …