INDEPENDENT RESEARCH ON TOBACCO CONTROL IN GERMANY

Abstract

In their article, “Tobacco Industry Influence on Science and Scientists in Germany,” Gruning et al.1 described the various methods by which the tobacco industry distorts science: (1) suppression of unfavorable research results, (2) dilution through selective funding of research and recruitment of scientists, (3) distraction of the attention from smoking as a cause of tobacco-related diseases, (4) concealment of the relationships between scientists and the tobacco industry, and (5) manipulation of publications. I congratulate the authors for their in-depth research on tobacco industry manipulations in which several leading German public health scientists were involved. However, these findings must not be allowed to detract from the important achievements of independent medical and public health researchers in Germany. Recently, researchers from the German Cancer Research Center, the University of Heidelberg, and the University of Munster presented valid estimates of the mortality due to passive smoking in Germany of at least 3300 deaths per year.2 After the weakening of public health research and practice because of misuse during the Third Reich, several decades were needed to reestablish the “new public health” in Germany. The activity of scientists and politicians led to the funding of 5 big public health research consortia by the Federal Ministry of Science and Technology and the founding of the first school of public health in the German-speaking region of Europe at the University of Bielefeld in 1994. As chair of the university’s Department of Public Health Medicine, one of my first actions was to implement a health promotion program at the university with a major focus on smoking cessation. In the context of this project my coworkers and I faced severe opposition from faculty, the university administration, and particularly reviewers of public health research grants. These obstructions signaled that public health in Germany was not yet ready to fight smoking in higher educational settings. It took 10 years to make the Bielefeld university hall partially smoke-free. Our epidemiological studies on university students’ health resulted in numerous publications (e.g., Kramer et al.3) and the implementation of effective interventions for tobacco-related prevention in the university setting. The concept of “new public health” in Germany is characterized by the extension of the medical risk factor model to include psychosocial dimensions and a health promotional perspective. However, this innovative concept is doomed to failure if the fundamental biomedical mechanisms of health and disease determinants are unknown or ignored. I hope that the increased awareness of the tobacco industry’s manipulations will speed up the long-overdue passage of legislation requiring smoke-free kindergartens, schools, universities, hospitals, work environments, and restaurants in Germany.