-Caveat Lector- >From the National Post http://www.nationalpost.com/story.asp?f=991002/92414 {{<Begin>}} Saturday, October 02, 1999 Fascism and the campaign to end smoking Pierre Lemieux National Post The Nazi War on Cancer (Princeton University Press, 1999) by Robert N. Proctor book cover. >From the vantage point of a late-20th-century observer, the public health policies of the National Socialists who ruled Germany from 1933 to 1945 seem surprisingly modern. Those policies are illuminated in Robert N. Proctor's most recent work, The Nazi War on Cancer (Princeton University Press, 1999), which documents the war against cancer and other public health campaigns by the Nazis. A historian of science at Pennsylvania State University, Prof. Proctor has written extensively on medicine, public health and their relations with politics, especially with National Socialism. The Nazis were known, and admired, for implementing the most progressive public health policies in their time. They applied state-of-the-art research and regulation to occupational, environmental and lifestyle diseases. Cancer was declared "the number one enemy of the state." Nazi policy favoured natural food and opposed fat, sugar, alcohol and sedentary lifestyles. The existing temperance movement against alcohol and tobacco became more active under the Nazis, who were involved in what Prof. Proctor calls "creating a secure and sanitary utopia." The longest chapter of Prof. Proctor's book is devoted to tobacco, "a focus justified," explains the author, "by the startling fact -- heretofore unnoticed -- that Nazi Germany had the world's strongest anti-smoking campaign and the world's most sophisticated tobacco disease epidemiology." It is well-known that Hitler himself was a rabid anti-smoker, but the anti-smoking movement and interventionist public policies of the Nazi era involved much more than Hitler's personal whims. Tobacco was attacked as a "relic of a liberal lifestyle" and as "masturbation of the lungs." Medical researchers in Nazi Germany, some with strong Nazi connections, first established a statistical link between smoking and lung cancer. Half a century before the Environmental Protection Agency enrolled junk science against "environmental tobacco smoke," anti-tobacco activist Dr. Fritz Lickint coined the term "passive smoking." (He also thought that coffee was a carcinogen!) The Nazis enacted many anti-smoking controls, including restrictions on advertising and bans on smoking in many workplaces, government offices, hospitals and, later, in all city trains and buses. Women could not legally purchase cigarettes in certain places. "The German woman does not smoke," proclaimed a Nazi slogan. In 1941, the Institute for Tobacco Hazards Research was created under the direction of Karl Astel. A dedicated Nazi who committed suicide in April, 1945, Mr. Astel thought opposition to tobacco was a "national socialist duty." As president of the University of Jena, he banned smoking in all university buildings. His institute produced the most path-breaking scientific work on the relations between smoking and cancer. Prof. Proctor is puzzled and distressed by the fact that "Public health initiatives were pursued not just in spite of fascism, but also in consequence of fascism" (his emphasis). But his book is weak on the analysis of this issue: In the closing chapter, where he tries to address it, he does not go much farther than stating that German fascism was a complex mixture of the good and the bad. Fortunately, the extensive documentation provided by the author lets us advance the analysis. Fascism is based on the subjection of the individual to the collective. As Benito Mussolini wrote about the 20th century: "For if the 19th century was a century of individualism, it may be expected that this will be the century of collectivism and, hence, the century of the State." The German brand of fascism, National Socialism, was characterized also by racist (as opposed to purely nationalist) beliefs. Everywhere in the West, on the other hand, public health doctrine has drifted from public-good concerns, such as sanitation or contagious diseases, toward a frontal attack on individual choices and politically incorrect lifestyles. The relationship between fascism and public health is probably more symbiotic than Prof. Proctor admits. After reading The Nazi War on Cancer, the careful reader will be well positioned to understand why fascism requires strong public health policies. The fascist state needs "valuable human material" -- or, as we would say today, healthy "human resources." Nazi slogans were more explicit than those present-day crusaders employ: "Your body belongs to the nation!" "You have the duty to be healthy!" "Food is not a private matter!" The Nazis' National Accounting Office anticipated today's health fascists by outlining the so-called economic costs of smoking. The public health mixture becomes more powerful with the added ingredient of racism. Public health campaigns contributed to the preservation not only of a population of taxpayers and conscripts, but also of the "German germ plasm." But this additive was not really required, as collectivism would have sufficed: "Germany's physician-fuhrers," Prof. Proctor notes, "were less concerned about the health of the individuals than about the vigor of 'the race,' the so-called folk community." Prof. Proctor distances himself from libertarians who would see fascism's invisible fist in today's repression of smoking: "My intention," he writes, "is not to argue that today's anti-tobacco efforts have fascist roots, or that public health measures are in principle totalitarian -- as some libertarians seem to want us to believe." But one must inquire whether there are institutional connections that tie public health and fascism in closer ways. Besides the fascists' need for healthy subjects, I suggest that still other connections help make sense of the disturbing evidence produced by Prof. Proctor. Both fascist policies and the modern public health ideology require a powerful state. Prof. Proctor reminds us that public health concerns were well known in the Weimar period, and the world's first state-supported anti-cancer agency was founded in Germany 33 years before the Nazis gained power. "What was new in the Nazi period were augmented police and legislative powers to implement broad preventive measures." The police powers implied by fascism allowed the public health ideology to show its real nature. The Nazi state apparatus had a "Reich Health Fuhrer" who established central registries for many diseases and addictions. Nazi Germany was a transparent society, where individuals were prevented from hiding their lives from the state. Thousands of "registered" alcoholics fell victim to the sterilization program under the Law for the Prevention of Genetically Diseased Offspring. Thus, fascism naturally leads to public health tyranny, which in turn requires extensive state powers. Such is the logic of political institutions and the growth of state power. The main danger of the present public health movement does not lie in its fascist roots so much as in its capacity to justify and call for tyrannical government power. Perhaps there is, in the moral field, a neat connection between the morality of an action and the goodness of the intentions underlying it. But, contrary to what Prof. Proctor seems to assume, no such correlation exists between human intentions and their social consequences. Since Bernard de Mandeville and Adam Smith, economists have appreciated that egoistic intentions can lead to good consequences for others. Similarly, good intentions can lead to undesirable consequences. As Friedrick Holderlin wrote: "What has always made the state a hell on earth has been precisely that man has tried to make it his heaven." It is therefore not surprising that the good public health intentions of the Nazis had some awful consequences, or that such a bad ideology as fascism led to some good consequences in terms of public health. Or did it? Can we say that Nazism produced good public health measures? Perhaps, but only if we are blind to the costs they imposed on individuals. No public health consequences are good in themselves, regardless of their costs. Even if we accept that smoking contributes to lung cancer, this does not justify prohibiting adults to do what they want with their own lives. Against the 20,000 German women who perhaps were saved from cancer by Nazi paternalist policies, one has to count not only the aggressions and deaths brought about by the political power needed to effect this outcome, but also the cost to these women in terms of their own liberty and dignity. Another issue looms behind Prof. Proctor's description of German life under the Nazis. Despite the tyrannical powers of the state, even despite the war, power was never completely centralized in Germany. Contentious issues continued to be debated (at least within the Aryan tribe), cancer research was pursued, and the tobacco industry fought against the prohibitionists. Life maintained an appearance of normality. Just as it does today. Of course, there is a difference of degree between the Nazi tyranny and the quiet administrative tyrannies we now live under. But perhaps future observers will wonder how, at the end of the 20th century, an apparently normal life could coexist with the accelerated onslaught on our liberties. Pierre Lemieux is visiting professor of economics at the University of Quebec at Hull. Reprinted with permission of The Independent Review, Oakland, Calif. RELATED SITES: (Each link opens a new window) Subversive Liberty The home page of Pierre Lemieux. Copyright © Southam Inc. 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