[Tobacco control politics in Germany. Evidence, success, and barriers]

Abstract

Structural measures of tobacco prevention are effective and cost-efficient measures to reduce tobacco consumption and the related health and economic consequences. However, Germany has been very reluctant in implementing tobacco control laws for several decades. Only recently has Germany increased its efforts in tobacco control, which has resulted in a decrease of tobacco consumption and in a decrease of smoking rates, especially in youths. This paper summarizes the evidence-based measures of tobacco prevention as well as the progress of recent German tobacco control policies. Finally, the barriers of further effective tobacco control policies are discussed and illustrated with examples. For decades, politics gave in to pressure and influence of lobbyists of the strong tobacco industry, which deceived the public and politics for their economic interests and in order to establish a high social acceptance of smoking. In addition, there is the phenomenon of "denialism", which means the convinced denial of scientific findings regarding smoking and smoking prevention in opponents of tobacco control, who are not directly affiliated with the tobacco industry.