The article by Starks (p. 1711) provides fresh evidence about the magnitude of the tobacco problem in prerevolutionary Russia and in the young Soviet Union of the 1920s. Before the 1917 October Revolution, the tsarist institutions already condemned as a poison a prevalent and addictive form of rolled cigarette with high nicotine content called papyrosa. But Starks also sheds light on a fascinating paradox characterizing the course of action toward tobacco consumption and addiction shortly after 1917. Even though the new Soviet state quickly became nonparliamentary, conferring extensive executive power to the Communist (or Bolshevik) Party, the attempts of its health authorities to drastically reduce the production and sale of tobacco products were hindered by economic and trade factions within and outside the Party. Thus, health authorities were confined to launching a national propaganda campaign denouncing tobacco as a poison causing mental and nervous illnesses threatening the state.

It is therefore tempting to compare Starks’s observations about the tied hands of Soviet public health to the Nazi attitude toward tobacco, as the German Third Reich (1933–1945) is another major case of a nonparliamentary state monopolized by a centralized party thought to have attempted to regulate tobacco consumption.

Vladimir I. Lenin, one of the two main leaders of the Bolshevik party, a nonsmoker, was intolerant toward tobacco. Starks reports the hilarious but telling story of Lenin selling bathroom tickets to Bolsheviks who wanted to smoke during meetings. Lenin seriously wished to ban tobacco and reduce access to it. In 1917, tobacco had been linked to lip and mouth cancers and to heart palpitations, but these suspicions were overpowered by the beliefs that it caused digestive problems, mental incapacities, weakened will, weakened heart, and sexual debilities in men and women, and that it inflicted collective harms on morality. Smoking was also blamed for its cost to individuals and society resulting from lost worker productivity, smoking-related fires, and exposure to nonsmokers in crowded housing and smoky social spaces. Bottom line: tobacco was a threat to the Revolution.

However, despite all his influence and the support of the Health Minister Nikolai Semashko, Lenin failed to impose any material, economic limitations to the production and sale of papyrosa in the first years of the Soviet Union. The opposition, both political and economic, was too strong. The health authorities were not even able to ban positive views of tobacco in advertising, popular literature, and movies.

Unable to restrict access to tobacco products, Lenin and Semashko were left with propaganda, which they used abundantly, as their only option to fight tobacco consumption. Its success is hard to assess but, according to Starks, Soviet appeals were everywhere, including testimony from workers that it inspired to try to quit.

In 1930, Semashko was removed, marking the end of the Bolshevik anti-tobacco propaganda. This coincided with Angel Roffo, in Argentina, reporting the carcinogenic effect of tobacco tar in animals1 and Frederik Hoffman, in the United States, providing the strongest pre–World War II evidence of a tobacco–lung cancer association in humans.2 After Semashko, anti-tobacco policy disappeared in the Soviet Union until the 1970s—that is, long after the negative health consequences of smoking had been recognized in the United Kingdom and by the Surgeon General in the United States.3 Symbolically, the successor of Lenin and Leon Trotsky at the helm of the Soviet Union, Joseph Stalin, was a heavy smoker.

The Nazis took power in Germany in 1933, at a time when the Soviet anti-tobacco campaigns were over but also when more was known (or at least accessible in the scientific literature) about the deleterious effects of tobacco on health. Adolf Hitler had stopped smoking by then and, as Lenin before him, was opposed to tobacco.

A group of racial hygienists closely collaborating with the Nazis produced a substantial amount of anti-tobacco propaganda but does not seem to have ever been able to translate this propaganda into an effective anti-tobacco policy. Between 1938 and 1944, several smoking bans were adopted, but they were seldom enforced or were ineffective.4(p482) I am not aware of a single document from the 12-year Reich that shows this propaganda material posted on real walls. I have not seen yet a report, diary, or other contemporaneous document discussing the anti-tobacco policy of the government in a positive or negative way, other than propagandist materials; the journal Reine Luft (Pure Air), published by the German Antitobacco League from 1938 to 1942; and official speeches by specific Nazi leaders.5(p159–162) On the contrary, evidence about the popularity of tobacco in Nazi Germany abounds. The Sturmabteilung (SA, Brownshirts) owned massively advertised cigarette brands referred to as Sturm-Zigaretten (the assault’s cigarettes). Many pictures of everyday life under the Nazis show people smoking. Among the leaders, Hermann Goering smoked cigars, and Heinrich Himmler and Joseph Goebbels smoked cigarettes, as did Magda Goebbels and Eva Braun, Hitler’s partner.4(p522) When Germany was losing the war, great efforts were made to guarantee the provision of cigarettes to the German troops. Schutzstaffel (SS) forces assigned on “special actions” in camps were granted five additional cigarettes per day. And so on.

The analogy between the Soviet Union and Nazi Germany in terms of these formidable state coercive powers being limited to propaganda to fight their moral enemy, tobacco, lends additional support to the hypothesis that the two studies from Nazi scientists in 19396 and 1943,7 which reported associations between tobacco and lung cancer, were part of this propagandistic material. They both analyzed series of cancer cases, but there is no evidence that their control groups free of cancer were truly recruited and interviewed.

If both the early Soviet Union and Nazi Germany used anti-tobaccoism as an attempt to impress upon the people the image of a superior, moral, clean, productive fighter or worker, there is an important difference between the two approaches. The Bolsheviks condemned tobacco addiction as a disease (Figure 1). Addiction was placed in the context of “neurasthenia.” Those with tendency to a weakened will (young men and women of any age) were deemed more susceptible to nicotine poisoning and unable to quit without a doctor’s help. They were offered services to cure the addiction, and social group support in therapy. This was consistent with the ideology of the October Revolution, which was primarily a social, anticapitalistic endeavor.

In Germany, the Nazis viewed tobacco addiction as an expression of racial impurity. The propaganda was tainted with racism, associating tobacco with communities (e.g., Jews, Roma, homosexuals, and Blacks; Figure 2) that the Nazis attempted to wipe out. This racist component contributed to discredit the Nazi anti-tobacco propaganda outside of Germany.

History will retain that nondemocratic regimes such as those of the Soviet Union and Nazi Germany failed to combat the economic control over tobacco production and sale because of internal and external political opposition and economic lobbies. This lesson can enrich our understanding of the reasons why, in contrast, effective tobacco prevention policies were the issue of the formidable confrontation that began in the United Kingdom and the United States after 1945 over the carcinogenic effects of tobacco.

See also Krementsov, p. 1693; Starks, p. 1711; Starks, p. 1718; Grant, p. 1725; Rivkin-Fish, p. 1731; Brown and Fee, p. 1736; and Ladwig and Brown, p. 1740.


I thank Professor Trish Starks and Nikolai Krementsov for their comments on a previous version of the editorial.


1. Roffo AH. Tobacco-induced cancer in rabbits [in German]. J Cancer Res Clin Oncol. 1931;33(1):321332. Google Scholar
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3. The Surgeon General’s Advisory Committee. Smoking and Health. Washington, DC: Public Health Service 1964. PHS Publication No. 1103. Google Scholar
4. Evans RJ. The Third Reich in Power. New York, NY: Penguin; 2006. Google Scholar
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Alfredo Morabia, MD, PhD @AlfredoMorabiaAlfredo Morabia is the Editor-in-Chief of AJPH. “Anti-Tobacco Propaganda: Soviet Union Versus Nazi Germany”, American Journal of Public Health 107, no. 11 (November 1, 2017): pp. 1708-1710.

PMID: 29019774