The Nazi anti-tobacco campaign used many methods like restrictions on smoking in public spaces, limiting tobacco advertising, restrictions on tobacco rations for women, restrictions on restaurants and coffeehouses, promoting health education, banning smoking in trams, buses and city trains, limiting cigarette rations in the Wehrmacht, organizing medical lectures for soldiers and increasing the tobacco tax. The anti-tobacco movement did not have much effect in the early years of the Nazi rule. Tobacco use increased between 1933 and 1939. But smoking by military personnel declined from 1939 to 1945. This anti-smoking campaign was more powerful and serious than the anti-tobacco movement in Germany at the beginning of the 21st century.
Anti-tobacco thoughts existed in Germany in the early 1900s. People who disliked smoking formed the first anti-tobacco group in the country named the "Deutscher Tabakgegnerverein zum Schutze der Nichtraucher" (German Tobacco Opponents' Association for the Protection of Non-smokers). Established in 1904, this organization existed for a brief period only. The next anti-tobacco organization, the "Bund Deutscher Tabakgegner" (Federation of German Tobacco Opponents), was established in 1910 in Trautenau, Bohemia. Other anti-smoking organizations were established in 1912 in the cities of Hanover and Dresden. In 1920, a "Bund Deutscher Tabakgegner in der Tschechoslowakei" (Federation of German Tobacco Opponents in Czechoslovakia) was formed in Prague, after Czechoslovakia was separated from Austria at the end of World War I. A "Bund Deutscher Tabakgegner in Deutschösterreich" (Federation of German Tobacco Opponents in Austria) was established in Graz in 1920.
These groups published journals advocating nonsmoking. The first such German language journal was "Der Tabakgegner" (The Tobacco Opponent), published by the Bohemian organization between 1912 and 1932. The "Deutsche Tabakgegner" (German Tobacco Opponents) was published in Dresden from 1919 to 1935, and was the second journal on this issue. The anti-tobacco organizations were also against drinking of alcohol.
Adolf Hitler was a heavy smoker in his early life, smoking 25 to 40 cigarettes daily. He gave up when he realized it was a waste of money. In later years, Hitler viewed smoking as "decadent" (meaning that it was bad for his health) and "the wrath of the Red Man against the White Man, vengeance for having been given hard liquor". He was sad that "so many excellent men have been lost to tobacco poisoning". He was unhappy because both Eva Braun and Martin Bormann were smokers and was concerned over Hermann Göring's continued smoking in public places. He was angered when a statue of Göring showed a cigar in his mouth. Hitler is often considered to be the first national leader to advocate nonsmoking.
Hitler disapproved of the military personnel's freedom to smoke, and during World War II he said on March 2, 1942, "it was a mistake, traceable to the army leadership at the time, at the beginning of the war". He also said that it was "not correct to say that a soldier cannot live without smoking". He promised to end the use of tobacco in the military after the end of the war. Hitler personally encouraged close friends not to smoke and rewarded those who quit smoking. However, Hitler's dislike for tobacco was only one of several reasons behind the anti-smoking campaign.
The Nazi reproductive policies were an important factor behind their anti-tobacco campaign. Women who smoked were considered to be more likely to age prematurely, and lose physical attractiveness; they were viewed as unsuitable to be wives and mothers in a German family. Werner Huttig of the Nazi Party's "Rassenpolitisches Amt" (Office of Racial Politics) claimed smoking mothers' breast milk contained nicotine. Martin Staemmler, an important doctor during the Third Reich, said that smoking by pregnant women resulted in a higher rate of stillbirths and miscarriages. This was supported by the well-known female racial hygienist Agnes Bluhm, in her book published in 1936. The Nazi leadership was concerned about this because they wanted German women to give birth. An article published in a German gynecology journal in 1943 stated that women smoking three or more cigarettes per day were more likely to remain childless compared to nonsmoking women.
Research and studies on tobacco's effects on the population's health were more advanced in Germany than in any other nation by the time the Nazis came to power. The link between lung cancer and tobacco was first proved in Nazi Germany, contrary to the popular belief that American and British scientists first discovered it in the 1950s. The term "passive smoking" (""Passivrauchen"") was coined in Nazi Germany. Research projects funded by the Nazis revealed many disastrous effects of smoking on health. Nazi Germany supported epidemiological research on the harmful effects of tobacco use. Hitler personally gave financial support to the "Wissenschaftliches Institut zur Erforschung der Tabakgefahren" (Scientific Institute for the Study of Tobacco Hazards) at the University of Jena, headed by Karl Astel. Established in 1941, it was the most significant anti-tobacco institute in Nazi Germany.
Franz H. Müller in 1939 and E. Schairer in 1943 first used case-control epidemiological methods to study lung cancer among smokers. In 1939, Müller published a study report in a reputed cancer journal in Germany claiming that prevalence of lung cancer was higher among smokers. Müller, described as the "forgotten father of experimental epidemiology", was a member of the National Socialist Motor Corps (NSKK) and the National Socialist German Workers’ Party (NSDAP). Müller's 1939 medical dissertation was the world's first controlled epidemiological study of the relationship between tobacco and lung cancer. Apart from mentioning the increasing incidents of lung cancer and many of the causes behind it such as dust, exhaust gas from cars, tuberculosis, X-ray and pollutants emitted from factories, Müller's paper pointed out that "the significance of tobacco smoke has been pushed more and more into the foreground".
Physicians in the Third Reich were aware that smoking is responsible for cardiac diseases, which were considered to be the most serious diseases resulting from smoking. The use of nicotine was sometimes considered to be responsible for increased reports of myocardial infarction in the country. In the later years of World War II, researchers considered nicotine a factor behind the coronary heart failures suffered by a significant number of military personnel in the Eastern Front. A pathologist of the Heer examined thirty-two young soldiers who had died from myocardial infarction at the front, and documented in a 1944 report that all of them were "enthusiastic smokers". He cited the opinion of pathologist Franz Buchner that cigarettes are "a coronary poison of the first order."