Lifestyle, health, and health promotion in Nazi Germany
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7480.1424 (Published 16 December 2004) Cite this as: BMJ 2004;329:1424All rapid responses
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How unlike our own time!
Competing interests:
None declared
Competing interests: No competing interests
Prof. George Davey Smith’s interesting article “Lifestyle, health,
and health promotion in Nazi Germany” (BMJ 2004; 329: 1424-1425) makes
much of the opposition of some nazi leaders and party institutions to
alcohol and tobacco. However, I feel that Prof. Smith paints a picture
which is too black-and-white and misses much of nazi hypocrisy surrounding
tobacco and alcohol consumption – a subject which arose incidentally
during research for my recently published study of Hitler’s personal
finances. (Hitler’s Fortune. Barnsley, 2004, Leo Cooper.)
While I would not disagree with Prof. Smith that there was ‘much
antismoking health promotion in Nazi Germany’ – certainly when compared to
Britain and the USA – it is a fact that Göring and Hitler both benefited
directly from a close association with the German tobacco industry,
especially the companies controlled by Philipp Reemtsma. Indeed, there is
circumstantial evidence that Hitler accepted a bribe from Reemtsma to
allow the latter’s products to be advertised in the Völkischer Beobachter,
the official party newspaper whose profits went into Hitler’s pockets. The
SA certainly mounted a campaign against Reemtsma and his tobacco products
– but not for any health reasons, rather to promote sales of their own
brands of cigarettes, profits from which went to keep the SA leaders in
the style to which they felt they were entitled. The Hitler Youth
certainly campaigned against smoking – and then issued cigarette cards
depicting German military might through Cigarette-Bilderdienst Dresden AS,
and similar companies, and there are no prizes for guessing where the
profits ended up. As for Robert Ley, a smoker, drinker and fornicator on a
grand scale, any attestation by him as to the benefits of not smoking
epitomises nazi hypocrisy at its worst.
On the general question of food and drink, it should not be forgotten
that while campaigns stressing the health benefits of wholemeal bread and
low-fat diets were certainly mounted, they were made more for strategic
and economic reasons under the wartime economy. The production of white
flour requires more energy than wholemeal and animal fat needed to be
conserved for the production of soap, some lubricants and other products.
The SS campaign against whipped cream is amusing, given that Hitler
was a major consumer of whipped cream, right up to his final days in the
Berlin bunker. Also, the slogan “Fighting power or whipped cream?” may not
be what it seems. According to a gay colleague of mine, “whipped cream”
was a nazi-era code phrase roughly approximating to “left-wing
intellectual faggot”. Unfortunately, I cannot offer a reference to
substantiate this.
Finally, on a minor point, Prof. Smith, citing “Racial hygiene.
Medicine under the Nazis.” claims that the Institute for the Struggle
against the Dangers of Tobacco was supported by money from Hitler’s
personal finances. This is possible, and in the time available I have not
been able to check his source, but in my investigation of Hitler’s
finances I found no evidence of his financing this or any other
institution from his personal fortune. What is more probable is that it
was funded from the Adolf Hitler Cultural Fund, a public trust largely
financed by the sale of special postage stamps. Less likely is that it was
funded from the Adolf Hitler Spende, a fund to which industrialists and
professionals contributed and which by 1942 was almost entirely under the
control of Martin Bormann – another notoriously heavy smoker and drinker,
but always anxious to please his boss.
In summary, though everything Prof. Smith says is correct, I feel the
climate of hypocrisy in which it flourished should not be ignored.
Sincerely,
Cris Whetton
Tampere, 2004.12.29
Dr. C. Whetton,
Näsilinnankatu 30-B32,
33200 Tampere,
FINLAND
e-mail: Cris.Whetton@sci.fi
Competing interests:
None declared
Competing interests: No competing interests
In order to reduce healthcare spending, federal, state and local
governments in the US are increasing controls over what were formerly
personal health choices. In the past, “public health” referred primarily
to communicable diseases. However, when taxes are paying everyone’s
health bills, private behaviors such as smoking, overeating and using
alcohol become quite arguably everybody’s business. The declaration by the
director of the NIH that obesity is a “public health emergency” has
initiated an educational campaign, with a call to use tax credits as
incentives. [Leonard] Under nationalized health care, is there any limit
to the state’s interest in personal choices of food and drink?
Indeed, virtually any activity could be viewed through the health
care lens, and the state might deign to forbid, favor or penalize anything
that might reasonably seen as a matter of “public” health. Further, the
demand for compliance in “public health measures” might emulate the
relentless expansion of rules governing U.S. nursing homes, by requiring
weigh-ins for the overweight or universal blood tests for drugs and
tobacco. Perhaps we might all be compelled to consume a specified diet or,
as suggested in the NHS, take a “polypill” [Wald] to reduce our national
rate of heart disease. For example, in 2003, Arkansas legislators
mandated that public schools record the body mass index of each student,
and send the results home with a warning and nutritional advice to
parents. [McKay] Senator Hillary Clinton recently expanded on this theme
by introducing the concept of “our collective health”. Citing productivity
losses, health expenses and national security, she endorses legislation
and national policy governing social and environmental factors to design
neighborhoods and schools, “control dangerous behaviors”, and implement
“required responsibility” for individual health concerns. [Clinton]
In the UK, for example, the annual cost to the NHS of diet-related
diseases is estimated in excess of £15 billion, and therefore
“[e]ventually, the UK will not be able to afford the health care made
necessary by inappropriate lifestyles and diet.” Thus there is a proposal
for a “national nutrition strategy”, including an independent agency with
regulatory powers. Quite beyond simple nutrition education, such a
national approach would also consider a “fat tax” or imposing legislation
on the food industry to achieve the desired product development, marketing
and pricing goals. [Fairweather 11Dec03] [Fairweather 8Sep03] This might
include “using government purchasing power to expand the market for fresh
healthy foods while counteracting the current subsidies supporting the
ingredients in high fat/sugar/salt products,” and placing restrictions on
“the marketing of junk food to children.” Television shows and Internet
sites should be altered “to ensure the support of active, healthy
lifestyles”. Further, expansion of government control over “transport and
rural development policies” was also recommended in order to increase the
level of physical activity. [UK Parliamentary]
The demand for public regulation of private behavioral choices may be
expanded to meet certain economic targets as well. In the UK and Canada,
options for health care are restricted by age. An extreme example appears
in China, the Population and Family Planning policy (enacted into Law in
2002) restricts parents to one child, except under limited circumstances.
These measures have prevented some 300 million births, which “reflects
both the fundamental and long-term interests of the people and benefits
the social and economic development of the country.” [China.org] However,
measures to achieve this have included heavy fines as well as compulsory
sterilization and abortion. [Gilman]
Similarly, euthanasia, initially intended as a last resort to
alleviate suffering, may expand to the point of death on demand. Over
time, the Netherlands has moved “from assisted suicide to euthanasia, from
euthanasia for the terminally ill to euthanasia for the chronically ill,
from euthanasia for physical illness to euthanasia for psychological
distress and from voluntary euthanasia to nonvoluntary and involuntary
euthanasia.” [Hendin 1996] Such “termination without request or consent”
has been applied to infants as well. The concern has been that public
health system rationing may exert pressure not just to limit spending on
certain individuals, but to subtly or overtly coerce them to be
euthanized. [Hendin 1997] [Bristow 1996] [van der Heide]
If it is the duty of the government to prevent people from harming
the body by what is ingested (e.g. tobacco, alcohol, high fat content),
surely there can be no objection to the state limiting those activities
that might also result in harm and public expense. Riding a motorcycle,
skiing and rock climbing and other high-risk activities become fair game.
Further, if the government demands the right to determine what the human
body can or cannot consume, there is no good reason to limit its interest
in the effects of media on behavior and the human mind. In order to
reduce health costs and prevent harm to society, preventing people from
reading bad books or advertisements, listening to bad music or speeches
and watching bad TV shows or movies should quite reasonably fall under the
purview of the state. Even discussing forbidden behaviors could be
forbidden, not unlike legislation in Canada regarding “hate speech” which
exposes the increasing trend toward censorship for “expressing thoughts
that the state defines as improper” [Leo]. However, because freedom
really means the freedom to make mistakes, this kind of society is no
longer a democracy by any means, and no longer free, except free to obey.
[Mises]
Leonard M, US launches a fight against obesity; The Boston Globe,
10Mar04
(http://www.boston.com/news/nation/articles/2004/03/10/us_launches_a_figh...
accessed 3/11/04)
Wald NJ, Law MR, A strategy to reduce cardiovascular disease by more
than 80%; BMJ 2003;326:1419 (28 June)
McKay B, In Arkansas, Schools Plan to Score Children's Weights; Wall
Street Journal August 20, 2003.
(http://online.wsj.com/article/0,,SB106131890160617100,00.html ; accessed
3/17/04)
Clinton H., Now Can We Talk About Health Care?; New York Times
Magazine April 18, 2004;
http://www.nytimes.com/2004/04/18/magazine/18POLICY.html?ei=5007&en=04fa...
(accessed 12/19/04)
Fairweather-Tait S, Healthy diet, healthy body, healthy economy; ph7
Magazine, Issue No.8, 11Dec03
(http://www.epolitix.com/EN/Publications/PH7/8_1/BA960509-1E9C-42ED-8BCD-
FC01942031EB.htm; accessed 3/11/04)
Fairweather-Tait S, Why the UK needs a national nutrition strategy;
Institute of Food Research, news release 8Sep03
(http://www.ifr.bbsrc.ac.uk/Media/NewsReleases/nutrition_strategy.html)
UK Parliamentary Inquiry into Obesity, International Association for
the Study of Obesity; Press Statement Jan 29 2004
(http://www.iotf.org/media/iotfjan29.htm; accessed 11Mar04)
UK Parliamentary Inquiry into Obesity, International Association for
the Study of Obesity; Press Statement Jan 29 2004
(http://www.iotf.org/media/iotfjan29.htm; accessed 11Mar04)
China.org; Family Planning Law and China's Birth Control Situation,
(http://www.china.org.cn/english/2002/Oct/46138.htm; accessed 3/11/04)
Gilman BA, New York, Chairman, House of Representatives; Forced
Abortion and Sterilization in China: the View from the Inside; Hearing
before the Subcommittee on International Operations and Human Rights of
the Committee on International Relations, June 10, 1998
(http://commdocs.house.gov/committees/intlrel/hfa49740.000/hfa49740_0.HTM;
accessed 3/11/04)
Hendin H, Suicide, Assisted Suicide and Euthanasia: Lessons From the
Dutch Experience, Summary for Congressional Subcommittee on the
Constitution; 1996 (http://www.house.gov/judiciary/2169.htm; accessed
5/20/04)
Hendin H, Rutenfrans C, Zylicz Z; Physician-Assisted Suicide and
Euthanasia in the Netherlands: Lessons From the Dutch, JAMA; 4 June 1997,
(277): 1720-1722
Bristow LR, Physician-Assisted Suicide, Subcommittee on the
Constitution
Committee on the Judiciary; April 29, 1996
(http://www.house.gov/judiciary/2170.htm; accessed 5/20/04)
van der Heide A, van der Maas PJ, van der Wal G, et al., Medical end-
of-life decisions made for neonates and infants in the Netherlands;
Lancet. 1997 Jul 26;350(9073):251-5.
Leo, J.; Stomping on Free Speech, USNews.com, 4/19/04
(http://www.usnews.com/usnews/issue/040419/opinion/19john.htm; accessed
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Mises L.; Economic Policy: Thought for Today and Tomorrow; 2nd Ed.;
Free market books, New York; 2002, 1979 p. 22-3, 48
Competing interests:
None declared
Competing interests: No competing interests
When activists, fighting against the propaganda of anti-smoking
groups, make reference to current campaigns to demonize tobacco and the
Nazi regime of the 30's and 40's, anti-smoking groups puff up with ruffled
feathers and indignance. It hurts their feelings that what they do, "for
the betterment of mankind", is associated with such an evil empire.
A spade is a spade and the programs and actions of both the purveyors
of oppression in Nazi Germany and the elitist nanny groups of today fit
well within the same glove. It has often been said that anti-smoking
groups today have molded their campaigns from the campaigns of the Nazis.
I wonder if this “molding” is inadvertent, and merely the mindset found in
all groups seeking control by advocating oppression.
Competing interests:
Unpaid activist
Competing interests: No competing interests
Dear Sir,
Prof. Dr. med. Wolfgang H. Veil, director of the Medical University
Clinic, Friedrich-Schiller-University Jena,
published his book in Germany 1939.
My generation never heard about this scientist.
But he draw a picture of medical observation like Dürer.
He was able to bring into one coherent picture the puzzle of
Rheumatic Fever.
He draw the picture of acute rheumatic fever.
And he draw the complex picture of recurrent rheumatic fever.
He draw the lines of arthritis.
He draw the lines of neuritis.
He draw the lines of encephalitis.
He draw the lines of vasculitis, nephritis and carditis.
And he saw the connection between post-streptococcal-reactive-
diseases and diabetes and other inflammations.
If we could see his picture of disease,
we would be able to help many millions with penicillin again. All these
diseases are still with us. But we cut off the roots - we do not see the
connections between streptococci and inflammation.
Sincerely Yours
Friedrich Flachsbart
W. H. Veil: Der Rheumatismus und die streptomykotische Symbiose.
Ferdinand Enke, Stuttgart, 1939
Competing interests:
None declared
Competing interests: No competing interests
The Spanish were first
It seems anti-tobacco activism was discovered in Spain:
http://jama.ama-assn.org/cgi/content/extract/293/4/504-b?etoc
Competing interests:
None declared
Competing interests: No competing interests