Commentary: Pioneering research into smoking and health in Nazi Germany— The ‘Wissenschaftliches Institut zur Erforschung der Tabakgefahren’ in Jena

Susanne Zimmermanna, Matthias Eggerb and Uwe Hossfeldc

a Institut für Geschichte der Medizin, Klinikum der Friedrich-Schiller-Universität Jena, Jena, Germany.
b MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Bristol, UK.
c Institut für Geschichte der Medizin, Naturwissenschaft und Technik, Friedrich-Schiller-Universität Jena, Jena, Germany.

PD Dr Susanne Zimmermann, Friedrich-Schiller-Universität Jena, Humboldtstrasse 10, D-07743 Jena, Germany. E-mail: b6zisu{at}nds.rz.uni-jena.de

The Scientific Institute for the Research into the Hazards of Tobacco (Führer in health Wissenschaftliches Institut zur Erforschung der Tabakgefahren) was founded on 5 April 1941 at the Friedrich-Schiller University in Jena in the presence of political dignitaries such as the Reichsgesundheitsführer (regional party leader), Leonardo Conti, and the Regional Minister and Gauleiter of Thuringia, Fritz Sauckel.15 The Institute was the first of its kind worldwide. The inaugural ceremony was a festive occasion held in the main lecture theatre to the accompaniment of an orchestra playing Mozart. The President of the Reichsgesundheitsamt (Office of Public Health) of the Third Reich, Professor Hans Reiter gave the keynote address.6 He thanked Gauleiter Sauckel for his valuable personal efforts in setting up the Institute. The racial hygienist and Professor of Medicine, Karl Astel who was the Dean of the University of Jena and headed both the Office for Racial Affairs and the Office for Public Health and Social Affairs of the State of Thuringia, however, was the driving force and chairman of the Institute. Astel had earlier described abstinence from smoking as a ‘national-socialist duty’ and was himself a militant non-smoker. Addressing "His Magnificence Prof. Dr Astel", Reiter said that ‘by carrying out your plan, you have cleared a way through the undergrowth of objections put forward by selfish people which will become broader and broader in the future’. Please nurture this project which may save the German Volk hundreds of thousands of valuable workers.6

The ceremony of the foundation of the Institute was part of a conference on the ‘Tabakgefahr’ (the hazard of tobacco) which took place under the auspices of Reichsgesundheitsführer Conti in Weimar. On the occasion of this conference and the foundation of the Institute, Fritz Sauckel and Leonardo Conti telegraphed greetings to the Führer in Berlin. Adolf Hitler replied: ‘I am very grateful for the telegram received from the First Scientific Conference for Research into the Dangers of Tobacco and the official opening of the Scientific Institute which will serve these purposes in Jena. In reply to your greetings, I send my best wishes for your work which will liberate mankind from one of its most dangerous poison’.67

Best wishes were not the only support provided by Hitler. He made a donation of over 100 000 RM out of his personal resources to fund the establishment of the Jena Institute.6,8

The anti-smoking campaign in Thuringia

The developments at the university were accompanied by a massive campaign against smoking in Thuringia, which was under the auspices of Gauleiter Sauckel. For example, smoking in public by women under 25 years of age was prohibited.9 Within the framework of this campaign Astel banned smoking at the University of Jena on 1 May 1941. As Head of the Department of Public Health of the State of Thuringia, he subsequently also prohibited smoking in all hospitals, polyclinics and other health institutions. However, this campaign was not undisputed. Goebbel's Ministry of Propaganda agreed in principle, but considered that a nationwide campaign in the mass media would not be feasible because authorities such as teachers and doctors were setting a bad example by smoking themselves. Furthermore, leading figures in party and state, including Reichsmarschall Göring, indulged in tobacco in public.9 The Ministry argued that if the campaign was unsuccessful and had to be abandoned, the enforcing authorities would make fools of themselves. In general a campaign against smoking was not considered to be sensible in wartime.9 It is unclear to what extent the efforts in Thuringia, which had been conducted with the special agreement of Hitler, had been successful, but the campaign's success was probably modest at best.3,4

The research at the Institute

The work at the Institute was hampered by a lack of resources: the Institute never had its own premises and laboratories or staff, but was entirely dependent on the contributions made by other researchers at University of Jena, for example the Chair of Physiology, Professor Emil von Skramlik. In 1942, in a letter addressed to the racial hygienist, Professor Günther Just, Skramlik wrote: ‘As you know a Scientific Tobacco Institute has been set up in Jena in 1941 under the leadership of Councillor of State Professor Karl Astel, Dean of the Freidrich-Schiller University. I am heading the Department of Physiology at this Institute’.10

Just immediately became involved in the research activities of the Institute and in 1943 received a total of 3000 RM from the Institute's resources for experimental work.11 It is uncertain what research Emil von Skramlik performed in the Institute's Department of Physiology. It is clear from administrative records, however, that the Institute performed smoking trials in volunteers: on 20 October 1941, a ‘Mr L’ from Jena wrote an invoice for 12 RM for ‘smoking trials performed in June 1941’.12 Little is known about these trials which continued to be part of the research programme of the Institute at least until summer 1942. It was Astel's wish that the findings from the research should be disseminated in collaboration with Emil von Skramlik in a ‘Kulturfilm’ (documentary to be shown in cinemas). Von Skramlik built on documentaries of the poisonous effects of nicotine on marine animals he had shot previously.2 Unfortunately the material could not be traced after the war.

In addition to the physiologist von Skramlik, other physicians from Jena examined the effects of nicotine on the organism. Dietrich von Keiser from the Department of Surgery examined the effects of nicotine on stomach action. In 1943 these studies were accepted as von Keiser's ‘habilitation’ at the University, a qualification which authorised him to teach at the University.13 Unfortunately the relevant documents can no longer be located, but we do know that von Keiser intended to examine 400 volunteers, mainly SA men.14 The report of the referee state that von Keiser X-rayed 300 people and found differences in the secretion of stomach juices and stomach peristalsis between smokers and non-smokers.15 The pathologist Professor Eberhard Schairer16 performed animal experiments with the support of the Tobacco Institute and, together with his doctoral student Erich Schöniger, mounted an epidemiological investigation into the connection between smoking and lung cancer.17,18

Doctoral theses

Schöniger was not the only doctoral student working on tobacco-related issues. Between 1942 and 1945, seven doctoral theses dealing with the effects of tobacco and nicotine were completed at the Medical Faculty (Table 1Go). However, only three of these can unequivocally be attributed to the Tobacco Institute. It is unclear how many other students worked on tobacco-related theses but never submitted their work.


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Table 1 Tobacco-related doctoral theses submitted to the medical faculty of University of Jena in the 1940s
 
The first of the series of seven theses was entitled ‘The woman smoker’ and was submitted in 1942 by Gabriele Schulz and Käte Dischner. In addition to Astel, the Chair of Psychiatry, Professor Berthold Kihn co-supervised the dissertation which, with 127 pages, was rather more substantial than usual. The two students formulated the rationale for their study as follows: ‘In relation to the guidance of our people in health matters, which is of particular importance now that we are at war, the issue of smoking is clearly an important issue for discussion ... The findings from scientific research have documented the harmful effects of tobacco on the nation, however a large proportion of the German people has not yet been able to give up smoking’. The thesis should support women, ‘who as the carriers of life should be at the forefront of promoting health’, in their decision to quit smoking. The two students interviewed a total of 175 female smokers in order to document the negative consequences of smoking. Their sample included 75 women prisoners, some of them political prisoners, in three penal institutions in central Germany. Access to these women was ‘kindly facilitated’ by Astel.

Werner Feuerstein, a soldier who had been ordered to study medicine and who was a member of a student battalion in Jena, completed a thesis on ‘Nicotine deaths over the past 100 years’ in 1943. He examined 56 recorded deaths due to nicotine poisoning, including accidental deaths after ingestion of pesticides, murders and suicides related to nicotine ingestion. Heinz Held, on the other hand, investigated ‘the effects of nicotine on the ion ratio of potassium and calcium in the human body’ in a dissertation completed in 1944. In his introduction he wrote ‘with the firm commitment of the leaders of our state to form healthy and strong future generations who can take on the great tasks of the future, the issue of nicotine has become the focus of attention’. Rolf Schroder's thesis from 1944 on ‘The neurological damage inflicted by tobacco. Compilation of known cases’ documents that neurologists and psychiatrists had developed an interest in the ‘Tabakgefahr’.

In 1944 the first thesis to be performed under the direct responsibility of the Tobacco Institute was completed. It was an experimental piece of work which dealt with ‘the effect of nicotine on worms’. The experiments were performed by the student Lore Wenzel under the supervision of Emil von Skramlik. In a further dissertation which was submitted in 1944 by Maria Schumann, the poisonous effects of nicotine in white mice, guinea pigs, rabbits and frogs which had been kept in a smoke-filled room for extended periods of time were described. Emil von Skramlik again supervised this work. The scientifically most important thesis is of course the study by Erich Schöniger. Schöniger worked under the supervision of the pathologist, Eberhard Schairer16 on ‘Lung cancer and tobacco consumption’. Their results were published in ‘Zeitschrift für Krebsforschung’ in 194317 before the thesis was submitted in 1944. This landmark study is published for the first time in English in this issue of the journal.19

A number of scientists from outside the University of Jena contributed to research at the Institute. In addition to Günther Just, other scientists such as the Director of the Institute for Racial Hygiene at the German University in Prague, Professor Karl Thurns and the pharmacologist, Professor Gustav Kuschinsky, also from Prague, conducted research in collaboration with the Institute and received financial support from the Institute. Karl Astel also invited one of the best known tobacco researchers of the time, Fritz Lickint, to collaborate with the Institute.20 The gynaecologist, Paul Bernhard from Duisburg, made use of the focus on tobacco at the University of Jena and submitted his habilitation on ‘The effects of tobacco poisons on the health and fertility of the woman’ in January 1942. The process was successfully concluded in March 1942 and the revised version of Bernhard's text was published less than a year later.21

Despite all the activities of Karl Astel, the Scientific Institute for Research into the Dangers of Tobacco achieved only marginal scientific significance and reputation. Astel committed suicide ten days before the end of the war, presumably to avoid facing the consequences of his activities as a leading racial hygienist in the Third Reich and the Institute was disbanded and remained forgotten for half a century.2,3,5

References

1 Zimmermann S. Die Medizinische Fakultät der Universität Jena während der Zeit des Nationalsozialismus. Habilitationsschrift. Universität Jena, 1993.

2 Zimmermann S. Die Medizinische Fakultät der Universität Jena während der Zeit des Nationalsozialismus. Berlin: VWB Verlag, 2000, pp.104–09.

3 Smith GD, Ströbele SA, Egger M. Smoking and health promotion in Nazi Germany. J Epidemiol Community Health 1994;48:220–23.[ISI][Medline]

4 Smith GD, Egger M. Smoking and health promotion in Nazi Germany. J Epidemiol Community Health 1996;50:109–10.

5 Proctor R. The Nazi War on Cancer. Princeton: Princeton University Press, 1999.

6 Reiter H. Ansprache bei der Eröffnung des 1. Wissenschaftlichen Instituts zur Erforschung der Tabakgefahren an der Friedrich-Schiller-Universität Jena am 5. April 1941. Münch med Wschr Nr 25, 20 Juni 1941.

7 Thüringisches Hauptstaatsarchiv Weimar (THSAW). Thüringisches Ministerium des Innern (TMdI), E 960, Rundschreiben der Reichsärztekammer 3.6.1941.

8 Hoßfeld U. Gerhard Heberer (1901–1973). Sein Beitrag zur Biologie im 20. Jahrhundert. Berlin: VWB Verlag, 1997, p.84.

9 Bundesarchiv Koblenz (BAKo), NS 18/226, Schreiben des Abteilungsleiters. Propaganda an den Minister vom 24.5.1941.

10 Universitätsarchiv Jena, Best. S Abt. XLI, Nr.2, Schreiben Emil von Skramliks an Günther Just.

11 Universitätsarchiv Jena, Best. L 512, Schreiben Karl Astels an Günther Just vom 14.3.1943.

12 Universitätsarchiv Jena, Best. S Abt. XLI, Nr.2, Schreiben von Herrn L. an das Physiologische Institut vom 20.10.1941.

13 Universitätsarchiv Jena, Best. D 3517, Personalakte Dietrich von Keiser.

14 Universitätsarchiv Jena, Best. L 511, Schreiben Dietrich von Keisers an Karl Astel vom 22.10.1941.

15 Universitätsarchiv Jena, Best. L 381, Referat über die Habilitationsschrift von Prof. Dr. Nikolai Guleke vom 21.1.1943.

16 Schairer HU. In memoriam of my father, Prof. Dr. med. Dietrich Eberhard Schairer. Int J Epidemiol 2001;30:28–29.[Free Full Text]

17 Universitätsarchiv Jena, Best. L 512, Schreiben Eberhard Schairer an Karl Astel vom 14.11.1941.

18 Schairer E, Schöniger E. Lungenkrebs und Tabakverbrauch. Z Krebsforsch 1943;54:261–69.

19 Schairer E, Schöniger E. Lung cancer and tobacco consumption. Int J Epidemiol 2001;30:24–27.[Free Full Text]

20 Universitätsarchiv Jena, Best. L 512, Schreiben Fritz Lickint an Karl Astel vom 21.4.1941.

21 Bernhard P. Der Einfluß der Tabakgifte auf die Gesundheit und die Fruchtbarkeit der Frau. Jena: Verlag von Gustav Fischer, 1943.