On playing the Nazi card - wispofsmoke.net · On playing the Nazi card ... The industry’s...

On playing the Nazi cardProfessor Robert N Proctor

Schneider and Glantz in this issue (seepage 291) chronicle the industry’s long-standing efforts to characterise tobaccocontrol as ‘‘Nazi’’ or ‘‘fascist’’.1 The indus-try’s rant has a certain superficial plausi-bility: the Nazis had one of the world’sstrongest anti-cancer campaigns, one cen-tral feature of which was to curtail tobaccouse. Hitler himself stopped smoking in1919, throwing his cigarettes into theDanube in an act of defiance he latercredited for helping the triumph ofNazism. The three main fascist leaders ofEurope (Hitler, Franco and Mussolini) alleschewed tobacco, whereas Roosevelt,Stalin and Churchill all were avid smokers.2

The tobacco industry finds such factsuseful, which is why the front groupFOREST (Freedom Organisation for theRight to Enjoy Smoking Tobacco) onceoffered my 1988 book, Racial Hygiene:Medicine Under the Nazis, for sale as ‘‘vital’’for understanding ‘‘the statist and patern-alist world view of the Nazis’’ and ‘‘thehealth fascism of contemporary anti-smok-ing and ‘health’ lobbies’’.3 Schneider andGlantz rightly conclude that the industry’sinterest in such matters has nothing to dowith German history, nor with the realitiesof fascism, but rather with an opportunis-tic effort to do whatever it can to keepselling cigarettes.

The industry’s reductio ad Hitlerum issuperficial, and ahistorical. The Nazisexcelled at rocketry—does this mean thatthe Apollo mission was ballistic fascism?Many Nazis urged fitness and healththrough exercise: is jogging thereforeathletic fascism? The fact that healthfulor progressive policies were occasionallyendorsed by the Nazis does not mean theyare inherently fascist or oppressive.

The industry and its allies push the Nazianalogy, but they never probe it very far.They never point out that the Germancigarette industry collaborated closely withthe Nazi government (in confiscatingtobacco firms in occupied territories, forexample), or that tobacco taxes provided amassive source of revenue for the Nazistate. They never point out that the‘‘Brownshirts’’ had their own brand ofcigarette—the ‘‘Sturm-Zigarette’’—or that

tobacco taxes helped prop up the Nazi state(more than half of all storm-trooperincome, for example, was from tobaccotaxes).2 They never point out that whileNazi authorities tried to curtail smoking,the industry was already powerful enoughto resist most of these encroachments. Thefact is that the Nazi war on tobacco wasnever waged as effectively as, say, thedestruction of the Jews. Cigarettes weredistributed to German soldiers throughoutthe war, and cigarettes were still beingshipped to concentration camps as late asthe spring of 1945. Advertising bans wereimposed, along with bans on smoking incertain indoor spaces (notably Nazi partyoffices), but cigarette consumption actuallygrew throughout the first eight years of theThird Reich, until war pressures finallycaused a decline.2

Schneider and Glantz are right to see thecharge of ‘‘health fascism’’ as simply oneamong many rhetorical tricks used by theindustry to try to marginalise public healthadvocacy. Arguments of this sort can, infact, already be found in the 1930s, whenthe German tobacco industry ridiculedanti-tobacco activists as ‘‘fanatic psycho-paths’’,4 ‘‘ascetics’’ and ‘‘Muradistin’’,5

with the latter term recalling SultanMurad IV of Turkey’s Ottoman Empire,said to have put to death anyone caughtsmoking. German tobacco manufacturersalso defended themselves by setting up theTobaccalogia medicinalis and other bodiesto sow the same kind of scientific doubtlater coughed up by Hill & Knowlton andthe Tobacco Institute. One interestingdifference: Nazi health authorities recog-nised this as a sham and forced the closureof the Tobaccalogia medicinalis soon afterits formation.2

The health fascism charge is only partof a much larger effort by the industry tomarginalise tobacco prevention as prud-ish, puritanical, or otherwise foolish,fanatic and antiquated. In a forthcomingbook6 I list some of the many expressionsused by the American industry to deni-grate the science demonstrating tobaccohazards, including: ‘‘Astounding’’,‘‘unwarranted, absurd’’ (1945); ‘‘coloredby prejudice’’ (1945); ‘‘crude experimenta-tion’’, ‘‘mere opinion’’ (1945); ‘‘at best,only suggestive’’ (1955); ‘‘nothing new’’(1957); ‘‘opinions of some statisticians’’(1957); ‘‘biased and unproved charges’’

(1959); ‘‘scare stories’’ (1959); ‘‘time-wornand much-criticized statistical charges’’(1959); ‘‘extreme and unwarranted con-clusions’’ (1959); ‘‘foggy thinking’’ (1962);‘‘a rehash of previously inconclusive find-ings’’ (1962); ‘‘the easy answer to acomplex problem’’ (1962); ‘‘fanciful the-ories’’ (1964); ‘‘propaganda blast’’ (1964);‘‘statistical volleyball’’ (1965); ‘‘utterlywithout factual support’’ (1965); ‘‘exag-gerations and misstatements of fact’’(1967); ‘‘guilt by association’’ (1968);‘‘‘guesses, assumptions, and suspicions’’(1968); ‘‘worse than meaningless’’ (1969);‘‘claptrap’’ (1969); ‘‘a bum rap’’ (1969);‘‘colossal blunder’’ (1970); ‘‘one of thegreat scientific hoaxes of our time’’(1970); ‘‘claims of the anti-cigaretteforces’’ (1971); ‘‘repeated assertion with-out conclusive proof’’ (circa 1971); ‘‘mis-information’’ (1972); ‘‘conventionalwisdom’’ (1974); ‘‘speculations, and con-clusions based on speculations’’ (1978);‘‘weak conjectures based on questionableassumptions’’ (1979); ‘‘unproved charges,exaggerated conclusions and largely one-sided interpretations of statistical data’’(1979); ‘‘half the story’’ (1981); ‘‘dogmaticconclusions’’ (1982); ‘‘Orwellian ‘OfficialScience’,’’ ‘‘scientific malpractice’’ (1984);‘‘outrageous claims’’ (1995); ‘‘statisticaljiggery pokery’’ (1995); ‘‘bogus statistics’’(1995); etc.

The ‘‘health fascism’’ charge positstobacco control as totalitarian, but it alsotaints it as deeply antiquarian. That haslong been a goal of the industry, to havetobacco health harms seem like ‘‘old news’’,stale. Tobacco control advocates are deni-grated as ‘‘modern Carry Nations inscience’’,7 ascetic drudges, fuddy-duddyparty-poopers. The explicit goal of RJReynolds’s Project Breakthrough from1994, for example, was to launch a ‘‘mas-sive, unprecedented public relations blitz’’tying anti-tobacco activism to 1920s-styleprohibition. The idea was to link modernpublic health activism to this ‘‘puritanicalwave to infringe, to restrict and possibly toeliminate personal freedoms’’.8

The target of such epithets changesover time, of course, and Schneider andGlantz rightly note that the ‘‘healthfascism’’ charge has most often beendeployed, especially in recent years, tocounter efforts to reclaim clean air for thecommons. One key rallying point was theepidemiological demonstration, in theearly 1980s, of significant health harmsfrom secondhand smoke. The industryresponded by organising a propagandacampaign identifying smoking essentiallyas a form of free speech. Free flags and

Correspondence to: Professor Robert N Proctor,Stanford University, History Department, CA 94305,USA; [email protected]

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copies of the US Bill of Rights weredistributed, and critics of public smokingwere identified as champions of illiberal-ism. This new libertarian alliance allowedthe industry to attack efforts to bansmoking indoors as statist and discrimi-natory, and a great deal of effort wentinto trying to identify public healthadvocacy with nanny-state puritanicalpaternalism. The industry also fosteredhistorical research bolstering the revisio-nist myth that tobacco’s critics especiallybefore the 1950s were ‘‘moralist’’ ratherthan ‘‘medical’’. This was yet anotherfalsification of history,9 designed toshow both the recency of medical cri-tiques of smoking and the essentiallyilliberal and antiquarian nature ofanti-tabagism.

Of course it is true that clean air is noguarantee of democracy, just as filth isnot a form of freedom. It is wrong,however, to characterise anti-tabagism astotalitarian or fascist. We should listenmore carefully to the voices of those withtumours, and learn from them what kindof freedoms they have gained from smok-ing. I suspect that those on this terminalend of smoking’s causal chain will havequite a different notion about whatconstitutes freedom, and wherein liestyranny.

One of the great challenges of tobaccocontrol is to come up with new andimaginative ways to think about how andwhere to intervene in the causal chainsthat lead to smoking. Visitors from

another planet would probably be aston-ished by our willingness to tolerate massdeath on a scale exceeding any otherpreventable cause of death.10 The strange-ness of our present situation can begrasped by imagining a world in whichevery convenience store sold lead-coatedchildren’s toys, or sacks of asbestos withgraphic warning labels covering, say, one-third of the sack. Equally odd is the factthat virtually all tobacco control effortsare directed at preventing consumptionrather than preventing production. Theindustry has managed to direct most ofour attention onto consumer choice (orinformation), leaving the means by whichcigarettes are spun forth into the worldunexamined, unhampered. Few peoplecan even imagine the inside of a tobaccofactory, fewer still know anything abouthow or where the world’s cigarette-mak-ing machines are made (clue: check outthe Hauni company in Hamburg). Thesemachines cause more death and injurythan any other invention in the history ofhumanity, but remain virtually unprobedby tobacco prevention scholars. That isthe world in which we live, thanks partlyto the success of the industry in framinghow we talk and think about tobacco,including schemes that make smokingseem a kind of freedom.

The grand challenge for tobacco pre-vention (a term I prefer to tobaccocontrol—we don’t have asbestos controlor lead control, and we don’t control polioor smallpox) is to broaden our sense of

what might be possible, and where wemight intervene. And until we broadenour imagination, and the media throughwhich it is expressed (film! contests!public art!), we should not be surprisedto have the world still think of tobaccoharms as ‘‘old news’’ and tobacco controlas tyranny.

Competing interests: I have been an expert witnessfor plaintiffs in tobacco litigation.

Tobacco Control 2008;17:289–290.doi:10.1136/tc.2008.026344

REFERENCES1. Schneider NK, Glantz SA. ‘‘Nicotine Nazis strike

again’’: a brief analysis of the use of Nazi rhetoric inattacking tobacco control advocacy. Tob Control2008;17:291–6.

2. Proctor RN. The Nazi war on cancer. Princeton, NJ:Princeton University Press, 1999.

3. Tame CR, Elliott N. Up in smoke: the economics,ethics and politics of tobacco advertising bans. 1991,Bates TIMN 378078-8119, p 37 at 8118.

4. Aschenbrenner H. ‘‘Forschung oder Behauptung,’’Deutsche Tabakzeitung, 47 (20 Nov 1940), cited inReine Luft 1941:36.

5. Becher G. Sind Wir wirklich Muradisten? Reine Luft1939:119–20.

6. Proctor RN. Golden holocaust: a history of the globaltobacco plague (forthcoming).

7. Wade CB Jr. 13th Annual RJR supervisors meeting,health update. RJR Management Bulletin 15 (1963):No 16 p 4, Bates 500034004.

8. Reynolds RJ. Project Breakthrough, 1994, Bates513206927–6930.

9. Kyriakoudes LM. Historians’ testimony on ‘‘commonknowledge’’ of the risks of tobacco use: a review andanalysis of experts testifying on behalf of cigarettemanufacturers in civil litigation. Tob Control2006;15(suppl 4):iv107–16.

10. Proctor RN. Tobacco and the global lung cancerepidemic. Nat Rev Cancer 2001;1: 82–6.

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‘‘Nicotine Nazis strike again’’: abrief analysis of the use of Nazirhetoric in attacking tobaccocontrol advocacyNick K Schneider,1 Stanton A Glantz2

Germany has a long record of pro-tobaccoindustry activities and weak tobaccocontrol policies.1–3 In contrast, during theNazi era in the 1930s and 1940s, Germanypromoted smoke-free public places, adver-tising restrictions and epidemiology link-ing smoking to lung cancer, infertility andheart disease.4–7 Although the Naziapproach to tobacco control was ambiva-lent and complex, often building on pre-existing policies and with poor enforce-ment,8 9 the association with the Nazishas been widely suggested as one reasonfor Germany’s modern weakness ontobacco control.10–12 Although Proctorcautioned against the oversimplistic inter-pretation of his work in The Nazi War onCancer5 and emphasised that the intro-duction of tobacco control measures bythe Nazis did not make tobacco controlinherently fascist,4 the tobacco industryand its front groups abused and distortedhistory to condemn tobacco control mea-sures as Nazi policies and its advocates as‘‘health fascists.’’8

Plans to introduce smoke-free environ-ments in several German states byJanuary 2008 fuelled an extensive publicdebate, including cover articles in themajor national news magazines DerSpiegel13 and Der Stern.14 Libertarian pro-tobacco activists started using ‘‘Nazi’’rhetoric to discredit journalists and publichealth experts.10 15 16 Analogies with Nazisymbols, including the use of the yellowStar of David on a pro-smoking T-shirt(fig 1) and in a TV news broadcast, wereused to liken the treatment of smokers tothe stigmatisation and discrimination ofJews under the Nazis.17–19 Against the

background of Germany’s history, theseaccusations are particularly charged.

Members of the German subsidiary ofthe US smokers’ rights organisation FightOrdinances and Restrictions to Controland Eliminate Smoking (FORCES),Netzwerk Rauchen—Forces GermanyeV, discussed suing a German tobaccocontrol champion and head of theGerman WHO Collaborating Centerfor Tobacco Control, alleging‘‘Volksverhetzung’’ (Agitation of thePeople), an accusation typically directedagainst neo-Nazis.15 Under German lawincitement of hatred against a minority ispunishable with up to five years inprison.(Strafgesetzbuch, Section 130).20

The tobacco industry and smokers’rights groups21–24 have evoked the rhetoricand symbolism of Nazi Germany todescribe public health authorities andadvocates as oppressors who discriminateagainst smokers since at least the late1960s. Although ‘‘Nazism’’ and ‘‘fascism’’are not synonymous, they are often seenby the public as being the same, and wereprobably conflated in their use against

tobacco control to evoke the same nega-tive feelings and reactions. In the pastGermany has been spared such rhetoric,probably because of fears of upsetting atobacco industry friendly government inan environment sensitive to Nazi compar-isons.25 This article traces how thetobacco industry developed and promotedNazi and health fascism rhetoric fordecades around the world.

METHODSBetween August and December 2007, wesearched the tobacco industry docu-ments made available as a result oflitigation in the United States (www.legacy.library.ucsf.edu, bat.library.ucsf.eduand tobaccodocuments.org/). Initial searchterms included ‘‘Nazi’’, ‘‘fascism’’ and‘‘health fascism’’ in several spellings, fol-lowed by standard snowball techniques.26

To assess the public debate we alsosearched for comments and articles on‘‘health fascism AND tobacco’’ and ‘‘NaziAND tobacco’’ on the internet. Secondarysource materials included online blogs ofmajor magazines and newspapers andopen discussion fora of smokers’ rightsgroups (FOREST, www.forestonline.org,FORCES, www.forces.org).

RESULTS

Nazism appears: the 1960s cancer debateAfter the 1964 US Surgeon General’sreport27 linked smoking and cancer, theTobacco Institute (TI), the US tobaccocompanies’ political and public relationsarm, worked to undermine the credibilityof researchers supporting this link.28 In1967, the president of the TiderockCorporation, one of the TI’s public rela-tions agencies,29 published an article inEsquire magazine that the TI widelydistributed to the media30–32 comparingnon-smokers and tobacco control mea-sures to Hitler and the Nazi regulations:‘‘Start thinking about the non-smokersthat you know. Well, round and roundand round we smokers go—and things,today, look black indeed. Mao Tse-tungwishes to legislate thought. Adolph Hitlerwished to legislate race. AnthonyComstock wished to legislate sex.Volstead wished to legislate sobriety.And Big Brother, now, wishes to legislateour habits …. We have laws whichpenalise discriminating in job against aman for his race, creed or color—but thehealth agencies are now issuing a bulletinstating that they will hire only non-smokers [emphasis in original]’’.33

1 Center for Tobacco Control Research and Education,University of California, San Francisco, California, USA;2 Department of Medicine and Center for TobaccoControl Research and Education, University of California,San Francisco, California, USA

Correspondence to: Professor Stanton A Glantz,University of California, San Francisco, Center forTobacco Control Research and Education, 530 ParnassusAvenue, Suite 366, San Francisco, CA 94143-1390, USA;[email protected]

Figure 1 T-shirt offered by a German event-marketing company in December 2007depicting the word ‘‘smoker’’ (‘‘Raucher’’) in theyellow Star of David, a symbol used tostigmatise Jews during the Third Reich.17 The T-shirt, which attempted to compare the‘‘persecution’’ of smokers, under smoke-freelegislation, to that of Jews under the Nazis, wasremoved from the company’s website afterpublic outrage.

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This rhetoric continued: a 1977 memoto the TI chairman from its vice-presidentcompared the anti-smoking campaignplans of the American Cancer Society(ACS) to General von Runstedt’s nearlyvictorious counteroffensive in thesecond world war: ‘‘Like the 1944 Naziblitzkrieg in the European Theatre, thenew ACS drive appears to have bothlimited tactical objectives and larger stra-tegic goals’’.34

Fighting smoke-free air in the 1970sThe modern movement for restrictions onsmoking in workplaces and public placesstarted in the United States in the 1970s.35

In 1978 and 1980 the tobacco industrydefeated efforts to pass laws requiringnon-smoking sections by popular vote.36

In 1980 the industry-funded oppositioncampaign ‘‘Californians against regula-tory excess’’ sent direct mail campaignmaterials to California voters headlined

‘‘You’re under arrest!’’ arguing, withregard to enforcement of the proposedlaw by the Health Department, ‘‘If you’relike me, you conjured up scenes from NaziGermany where no one was safe, andwhere children turned their parents in tothe authorities’’.37

Building an intellectual frame against‘‘health fascism’’: the 1980sAt the urging of US tobacco company RJReynolds, in 1978 the multinationaltobacco companies came together undertheir International Committee onSmoking Issues to commission ‘‘thirdparty’’ social science academics to developarguments to maintain the social accept-ability of smoking and undermine thecredibility of public health arguments,initially through its Social Costs/SocialValues project and later, in the 1990s,through Associates for Research in theScience of Enjoyment (ARISE).38–40 Thesethird parties rarely disclosed the nature oftheir relationships to the industry.

In a speech at the TI’s Winter Meetingin 1980, a syndicated columnist andtelevision news commentator comparedthe 1964 US Surgeon General’s report tothe Nazi propaganda against German andEuropean Jews before the second worldwar, then continued, ‘‘having been vic-tims since 1964, and even longer, ofviolent verbal propaganda abuse it isclearly possible that in the future, busi-nessmen will become the victims of actualviolence’’.41 In 1991, reacting to calls forregulations based on smoking-attributablehealth costs, R Tollison and R Wagner,two members of the industry’s SocialCosts Economist Network,42 publishedthe book The Economics of Smoking:Getting It Right,43 arguing that ‘‘fascismtechnically refers to a form of statesocialism where the government ‘man-ages’ the economy by making most or allimportant decisions for individuals(usually for some supposedly ‘higherpurpose’) without actually nationalizingall property. The anti-smoking lobbyadvocates a form of ‘health fascism,’ inwhich Health—irrespective of the desires,goals, and plans of individuals—is toutedas the only true aim of governmentpolicy’’.43 As part of the industry’s effortto fight advertising restrictions, industryconsultant and marketing professor JeanBoddwyn44–50 publicly argued that bans‘‘raise serious concerns about ‘healthfascism,’ censorship and behavior controlby governments’’.51

In 1988, the chairman and chief execu-tive officer of Philip Morris Companiesgave a speech at the Virginia Foundation

Figure 2 The advertisement ‘‘Where will they draw the line?’’ was part of Philip Morris’s 1995pan-European Advocacy Campaign.72 The demarcation of a small ‘‘smoking section’’ on a city mapand the header ‘‘Vogliamo creare un altro Ghetto?’’ (Do we want another ghetto?) resembles thelocation of the Jewish ghetto during the Third Reich. The advertisements were placed in pan-European and local press in the United Kingdom, France, Spain, Belgium, Luxembourg, Portugal andGreece.25 In some countries, Philip Morris opted out of the national implementation and only ran thecampaign through pan-European media, in Italy because of a changing political environment, in TheNetherlands because of colliding national campaigns and in Germany because of fears of upsettinga tobacco friendly government.

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for Independent Colleges in which heargued, ‘‘if fascism comes to America, itwill come in the form of a healthcampaign … But it may be that it’s notsuch a long step from cigarettes to redmeat and fast food, to nuclear powerplants, to fried chicken, to sitting on yourporch Saturday morning instead of join-ing the joggers’’.52

In the United Kingdom the ‘‘healthfascism’’ accusations were spearheaded bythe campaign director of the tobacco

industry-funded front group FOREST,24 aformer employee of the influentialInstitute of Economic Affairs (IEA), athink-tank co-financed by BAT since1963.53 After the retirement of theFOREST founder and chairman in 1989,he wrote an internal strategy discussionpaper that highlighted the appeal of the‘‘health fascism’’ argument and arguedthat the only way that the right to smokecould be preserved would be to link it up‘‘with the broader libertarian critique of

‘health fascism’ and the paternalism andauthoritarianism of the medical establish-ment’’.54 Two years later, FOREST pub-lished a report on the ‘‘The HistoricalOrigins of Health Fascism,’’ in which asenior lecturer in history at ManchesterMetropolitan University, explained howhealth fascism originated in the 19thcentury from the Victorian vaccinationdebate and the English social hygiene andeugenics movement.55 In the forewordformer FOREST chairman Lord Harris ofHigh Cross, head and founder of the IEA,and director of The Times (London), linkedthe treatment of smokers to the persecu-tions under the Nazis, arguing that ‘‘afterall, the German Fascists are chieflyremembered for imprisoning, even killing,people with whom they disagreed, whilethose busily persecuting smokers stopwell short of such penalties […] in manyother respects there are striking simila-rities’’ [emphasis in original].55

Also in 1991, a public relations con-sultant to RJ Reynolds reported opposingthe political correctness movement in hismonthly report and suggested identifyingand, when possible, ‘‘building allianceswith academics who oppose the NewFascism’’.56 The recruitment of third-partyallies among academics in social sciencescontinued; Walter Williams, professor ofeconomics at George Mason Universityand chair of the industry-funded 1997Social Costs Forum, published pro-indus-try op-eds criticising the science behindsmoke-free legislation in the WashingtonTimes and the New York Tribune,57 inwhich he stated that ‘‘some of the world’smost barbarous acts, from slavery togenocide, have been facilitated by bogusscience … The Food and DrugAdministration’s Dr David Kessler, alongwith Rep Henry Waxman andEnvironmental Protection Agency headCarol Browner, are modern-day leadersof that ugly scheme. Don’t get me wrong;I’m not equating them to Hitler. Butwhat distinguishes them is a matter ofdegree but not kind’’.58 The same languagehas been used by influential physiciansand epidemiologists with deep seatedanti-authoritarian sentiments, such asthe former regular Lancet contributor,tobacco industry consultant and ‘‘verykeen and active member of ARISE’’ PetrSkrabanek,59–62 in his critique on ‘‘life-stylism’’63 and ‘‘coercive healthism’’,64 aswell as ARISE-participant BruceCharlton65 in ‘‘How Hitler tried to stubout smoking’’, in which he compared thehealth promotion focus in the UK Healthof the Nation strategy66 to the propagandaused by the Nazis.67

Figure 3 A cover article on ‘‘The Dictatorship of the Non-smokers’’,88 published in the popular left-wing political magazine Veintitres in Argentina in 2003 in the context of a new administration with aministry of health that developed a national tobacco control programme.96 Symbols combiningcigarettes and swastikas are also used in other publications, mainly referring to Nicotine Nazis.97

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Playing the Nazi card to fight smoke-freeenvironments around the world: the 1990sDuring a demonstration against the UKNational No Smoking Day, in 1992,FOREST supporters dressed in Nazi SSuniforms thanked England’s secretary ofstate for health for ‘‘continuing the goodwork of his predecessors in NaziGermany’’.68 FOREST explained the back-ground of ‘‘health fascism’’ to the mediaand highlighted how the ‘‘various anti-food, anti-drink, and anti-lots-of-other-things groups’’ mirror the tactics of theanti-smokers.68 According to FOREST, thefocus on health fascism ‘‘evoked a parti-cularly interesting result from the media’’:while the ‘‘die-hard anti-smoking journal-ists’’ mocked and ignored it, othersrealised that it was a growing phenom-enon in British society.68

In response to growing pressure to limitsmoking in Australia in 1993, executivesfrom Philip Morris Australia suggested tothe chief executive officer of Philip MorrisInternational that Philip Morris ‘‘exploitthe extremism, what has been describedas the ‘Liberal Fascism’ of public interestgroups who seek to eliminate smoking’’and that ‘‘undermining the support forthese groups [would be] a platform for theindustry’s long term strategies’’.69

The same year, despite polling PhilipMorris had conducted in 198970 thatshowed stronger support for smokingrestrictions in some European countriesthan in the United States, Philip MorrisCorporate Affairs Europe suggested intheir ‘‘Smoking Restrictions 3 Year Plan’’to ‘‘pitch US practices as ‘extremist,’indicative of intolerance, risk aversionand health fascism (for example, viaARISE)’’, as one of their media targets.71

Confronted by an increasing number ofdraft smoke-free laws, Philip MorrisCorporate Affairs launched its pan-European Advocacy Campaign ‘‘Wherewill they draw the line?’’72 in 1995 toconvince opinion leaders that smokingrestrictions would not be supported inEurope.72 The aim was to frame thesmokers as victims, as described in theOctober 1994 market research report:‘‘What is clever about the campaign ideais that it makes the smoker the victim,whose rights need protecting, rather thanthe non-smoker who needs protectingfrom the smoker’’.72 The $2.9 millionadvertising campaign targeted Europeanand national legislators and civil servantsand consisted of a letter to employees andtwo different sets of advertisements,‘‘Pythagoras’’, ‘‘attacking excessive andover-complicated legislation’’ and‘‘Map’’, ‘‘dramatising the dangers of the

way things are going’’25 in major pan-European and national print mediathroughout the United Kingdom, France,Germany, Italy, Spain, Greece, Belgium,Luxembourg, Netherlands, Ireland,Portugal and Greece.

The Philip Morris ‘‘map’’ ads (fig 2)explicitly recalled the Third Reich’s Jewishghettos to argue that ‘‘excessive govern-ment regulation serves only to margin-alize the millions who choose to smoke,causing unnecessary tension and divisionbetween smokers and non-smokers’’.73

The demarcation of small ‘‘smoking sec-tions’’ on city maps placed near thetraditional Jewish quarters and the head-lines (for example, ‘‘Where will they drawthe line?’’ or ‘‘Do we want to createanother ghetto?’’ as used in the Italian[‘‘Vogliamo creare un altro Ghetto?’’] andPortuguese [‘‘Sera que queremos criar umnovo gueto?’’] versions) explicitly recallthe introduction of Jewish ghettos by theNazis.72 74

DISCUSSIONAs early as the 1970s, the transnationaltobacco companies already worked on aset of programmes using third party socialscience academics to construct an alter-native cultural repertoire to halt thedecline in social acceptability of smokingon global level.40 Besides the politicaladvocacy by the tobacco industry throughadvertisements, (secretly) commissionedreports and op-eds in the media, industry-supported front groups directly attacked

tobacco control initiatives with Nazirhetoric, either to fight the introductionof new legislation or to discredit andridicule tobacco control advocates.FORCES, a smokers’ rights organisation,uses similar strategies, as their tacticsinclude ‘‘constantly linking anti-tobaccoactivists either to fascism/Nazism/com-munism or to some sort of criminalconspiracy against smokers and thosepeople sympathetic towards FORCES’causes’’.75 (Unlike earlier ‘‘smokers’rights’’ groups where information intobacco industry documents demon-strates often undisclosed funding andmanagement by the tobacco industry,the documents are silent onFORCES.23 24 76–78) As of December 2007,the FORCES archives portal (http://www.forces.org/Archive/) documentedthis endeavour with 85 online newspaperarticles or commentaries including theword ‘‘Nazi’’, 61 including ‘‘fascism’’, 31including ‘‘Hitler’’ and 23 including‘‘Gestapo’’ (out of a total of 3724 articleson the tobacco debate).79 As such, thetobacco industry’s efforts to popularisethe images and rhetoric of Nazism havesuccessfully penetrated the popularmedia, including sources with no identifi-able ties to the tobacco industry80–87

(fig 388). Nazi imagery is also appearingin the new media, such as www.youtube.com, a potentially fruitful social network-ing site for tobacco marketers.89 BetweenOctober and December 2007, this websitepublished 19 short videos using extensiveNazi imagery to attack and ridiculetobacco control interventions, includingthe Irish smoke-free legislation, and orga-nisations like Action on Smoking andHealth (fig 4).

CONCLUSIONNazi and health fascism rhetoric has beenused and promoted for decades by thetobacco industry around the world.Against the background of Proctor’s sug-gestion that the use of Nazi rhetoricwould increase with stronger tobaccocontrol efforts,5 the current use inGermany is neither new nor a purelyGerman phenomenon, but probably a signof increasing strength of Germany’stobacco control movement. The use ofNazi and health fascism rhetoric can beregarded as part of an institutionalisedpractice of the tobacco industry and itsfront groups to discredit tobacco controlactivities and prevent the introduction ofeffective policies. ‘‘Playing the Nazi card’’is an established strategy developed firstin the United States and the UnitedKingdom, then widely used around the

Figure 4 The self-described propagandaminister of the fictional ‘‘Anti Smoking League.’’ridicules tobacco control interventions andorganisations in 19 short movie-clips on www.youtube.com. In most clips he is wearing Naziuniform and showing swastika and non-smoking sign flags on his desk. Some moviesend with links to www.forces.org and www.freedom2choose.info. (http://www.youtube.com/watch?v = 2X-PUT1WGRM, accessed 25November 2007.)

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world, so far, predominantly outsidecountries with a Nazi or fascist history.This imagery is now simply being appliedin Germany.

The tobacco industry is far from aban-doning this strategy. Capitalising on fearsof terrorist attacks in the Western world,this rhetoric is increasingly receiving anew focus, as more and more articles aimat the ‘‘Antismoking Ayatollahs’’ and the‘‘theocracy of the Tobacco Taliban,’’especially in the British Isles.90–95 Thetobacco control community should iden-tify and monitor the use of extremistimagery and rhetoric by the tobaccoindustry and its front groups, to unveiltheir strategies and counter their attackson effective tobacco control and itsadvocates. It remains to be unveiled ifthe Tobacco Taliban will one day replacethe Nicotine Nazi. In the meantime, suchrhetoric should not deter public healthadvocates (and the media) from educatingthe public about the adverse effects oftobacco use and secondhand smoke.

Acknowledgements: We thank Ernesto Sebrie, DanielCortese, Yogi Hendlin and Sarah Sullivan for helpfulcomments on this work.Both authors developed the research idea and designedthe study. NS collected the industry document anddrafted the manuscript, which was revised in colla-boration with SG. Both authors approve the final versionof the manuscript.

Funding: This work was supported by the NationalCancer Institute (grants CA-113710 and CA-87472). Thefunding agency played no part in the conduct of theresearch or in the preparation or revision of themanuscript.

Competing interests: None.

Received 27 December 2007Accepted 6 April 2008

Tobacco Control 2008;17:291–296.doi:10.1136/tc.2007.024653

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What this paper adds

c Following the introduction of smoke-free legislation in Germany and based on the falsepremise of similarities with Nazi policies, national public health leaders and mediasympathetic to tobacco control were accused of being ‘‘health Nazis’’ or ‘‘healthfascists’’.

c Historically accurate or not, the tobacco industry has drawn connections betweentobacco control and authoritarianism, evoking the rhetoric and symbolism of NaziGermany. The tobacco industry has used and promoted Nazi and health fascism rhetoricin the United States and United Kingdom and around the world for decades andsuccessfully penetrated the popular media, including sources with no identifiable ties tothe tobacco industry. Identification and monitoring of the use of extremist imagery andrhetoric are crucial to counter this strategy.

Commentary




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