Tobacco policies in Nazi Germany: not as simple as it seems
Summary
Objective
Reluctance to develop effective tobacco control measures in Germany has been attributed to the anti-smoking stance taken by the Nazis, which has encouraged pro-smoking groups to equate tobacco control advocacy with totalitarianism. This paper reassesses the scale and nature of tobacco control in Germany during the Third Reich.
Design
Analysis of documents and reports about the situation in Germany in the 1930s and 1940s supplemented by a review of Reich legal ordinances, party newspapers, health behaviour guidelines issued by Nazi party organizations, and interviews with expert informants.
Results
While there was considerable opposition to smoking in Nazi Germany, there was no consistent Nazi policy to combat smoking, and what did exist built on pre-existing policies. Although extreme measures were taken in isolated localities or by overzealous party members, there was a marked ambivalence to tobacco control at the highest levels. Many policies were contradictory; measures were often not enforced, and cigarettes were actively distributed to ‘deserving’ groups.
Conclusion
Policies on tobacco in Nazi Germany are much more complex than is often represented by those who invoke them to condemn those seeking to reduce the burden of disease caused by smoking.
Introduction
The tobacco industry and its supporters have linked contemporary proposals for tobacco control measures with Nazi policies. Recent examples often draw selectively on the descriptions by Davey Smith et al.1,2 and Proctor3–6 of Nazi campaigns against tobacco in Germany, even though Proctor warned specifically against this selective interpretation. In a section in his book entitled ‘Playing the Nazi card’, he suggested that the industry’s use of such arguments was likely to increase as tobacco control efforts gathered strength.3 Even when he was writing in the late 1990s, he was able to identify a number of examples, such as a 1995 advertisement by Philip Morris showing a map of Amsterdam with a small walled-off area marked ‘smoking section’, clearly intended to invoke the concept of a ghetto. Proctor’s prediction has proven correct, with tobacco control activists being attacked as fanatics while tobacco control measures widely accepted elsewhere are presented as unimaginable totalitarian attacks on individual liberty, comparable to those during the fascist regime in the 1930s and 1940s. For example, a search on the pro-smoking website, www.forces.org yields over 200 hits with the word ‘Hitler’. Other attempts to link the image of Nazism with tobacco control include ‘tobacco Gestapo’7 or ‘tobacco Nazis’8.
The message contained in them is exemplified by the following quote from the Forces website referring to a paper by Davey Smith et al.:1
‘This commentary depicts with great precision and accurate bibliographical references the astonishing similarity of the Nazi propaganda against smoking with the current propaganda of the antismoking industry. Had we removed the references to the Nazis, the reader would think that this is contemporary material…The resurgence of fascism under the guise of health is not new, and we better learn the lesson of history once and for all, or the price to pay for our ignorance will be dear indeed.’9
In a description of organizations active in the field of tobacco control on the same website, the US Department of Health and Human Services and the Centers for Disease Control and Prevention are accompanied by a picture of a Nazi swastika, symbolizing that they are considered ‘Dangerous organizations and social programs – usually state-endorsed – aimed at population behaviour conditioning and control by all means necessary, including intimidation, repression, force, regulation, etc.’10 These are not isolated incidents. A search on Google using the word ‘nico-Nazis’ yields over 1000 hits, including one where the term is used to label two of the authors of this paper. It should, however, be noted that these references are overwhelmingly in websites from the USA or the UK, and where they appear on German sites, it is almost always to express curiosity or surprise about their use.
While some senior Nazis, including Hitler, were strongly opposed to smoking and some Nazi policies did seek to discourage smoking, the authors concur with Proctor that the reality was more complex than is often portrayed and, in reality, there was considerable ambivalence at the highest political levels; an argument also advanced cogently in a recent paper by Lewy.3,11 This paper will build on the earlier analyses to look in more depth at the extent of this ambivalence, and provide new insights into the differing views taken by senior Nazi party officials.
Methods
The starting point was the seminal research by Davey Smith et al. and Proctor.1–3,5 Initial searches on PubMed and Google were followed by searches in, among others, the archives of the Institute of Contemporary History in Munich and the Bundesarchiv (Federal Archive) in Berlin. In brief, these included manual searches of legislation enacted between 1939 and 1945 (Reichsgesetzbücher), official publications (e.g. Deutsche Arbeitsfront) that may describe anti-smoking campaigns or guidelines on health behaviour, and a sample of major party newspapers and magazines (e.g. Das Schwarze Korps, Der Stürmer) for tobacco advertising and anti-tobacco media campaigns. Research in the Austrian National Library examined Reich-wide activities, including a manual search of the entire Reichsgesetzblatt volumes covering 1939–1945, the Reichsministerialblatt für das Dritte Reich, the Reichsarbeitsblatt and the Amtsblatt des Reichsarbeitsministeriums, as well as Reich-wide party newspapers (particularly the Völkischer Beobachter – Vienna Edition). In a follow-up search, specific issues of the Deutscher Reichsanzeiger und Preussischer Staatsanzeiger were searched for orders or decrees on tobacco control.
The documentation obtained was used to examine the nature of and attitudes to tobacco control during the Third Reich. In particular, it was examined whether the anti-tobacco activities undertaken were driven by individuals at lower levels within the system or whether they were part of a Reich-wide campaign, enjoying high-level political support. In addition, the authors assessed the extent of high-level support within the party for the more extreme campaigns run in some magazines (e.g. Reine Luft published by tobacco control activists and dedicated to the smoking issue) and for the activities of the Institute for the Struggle Against Tobacco Hazards at Jena University. An accompanying paper describes Nazi policies on tobacco in Austria.12
Results
History of tobacco control in Germany
As has been noted previously, long before the Nazis came to power (1933), Germany was a leader in both epidemiological studies on smoking-related diseases and policies against smoking.3,6,13 As early as the 18th Century, there were prohibitions on smoking in, for example, towns, forests, barns and bedrooms. The restrictions were primarily designed to reduce the risk of fire but there was also a strong undercurrent of morality, with smoking by women seen as socially unacceptable.14 These restrictions were relaxed in the early 19th Century as public health officials believed that smoke had sedative and anti-miasmatic qualities that could be useful in the face of cholera epidemics. However, in 1840, the Prussian authorities re-instated a ban on smoking in public places. Thus, state restrictions on tobacco long predated the Nazi era.3 The beginning of the 20th Century saw the creation of antismoking organizations in many countries; the first anti-smoking organization in Germany was launched in 1904. In the 1920s, several German studies suggested a link between smoking and lung cancer.15,16 Thus, the earliest German research on the effects of smoking, in particular the causal relationship between smoking and lung cancer, long predated research on this issue in English language papers, which have generally been seen as heralding the link between smoking and lung cancer.17,18 These early studies were not linked to Nazi ideology. Indeed, Fritz Lickint, one of the leading advocates of anti-smoking campaigns, was a social democrat who was vilified and denied promotion under the Nazis.3 Despite this experience and his opposition to Nazi ideology in general, he was a strong supporter of the Nazi campaigns against smoking.6 Indeed, during the Nazi era, Lickint formulated proposals for an anti-tobacco movement, including a smoking ban for youths under 18 years old, education of women by physicians on the dangers of smoking, production of nicotine-free/reduced tobacco, increased protection of non-smokers (e.g. in public), counselling for tobacco addicts (potentially linked to counselling on the dangers of alcohol), promotion of research on the dangers of smoking, and establishment of a tax-funded Deutscher Bund zur Bekaempfung der Tabakgefahren (German Alliance to Fight the Dangers of Tobacco).19
Nazi campaigns against and research on smoking
Although, as noted above, Germany was already a leader in tobacco control policies, the Nazi campaigns against smoking were much more wide ranging than previous campaigns. They comprised, primarily, an age limit of 18 years for smoking in public, advertising restrictions and smoking bans in some public places due to fire hazards and the dangers of ‘passive smoking’ (a term already coined by Lickint in 1939).20 There was a strong focus on preventing smoking by women, linked closely to an idealized view of German wives and mothers. Thus, actions against smoking were often linked to similar actions against the wearing of cosmetics.21
Some restrictions, e.g. the 18-year age limit for smoking (and drinking of spirits by those under 16 years) issued on 9 March 1940, went no further than comparable legislation in many other countries.22 Moreover, a 1943 police order aimed at protecting young people demonstrates considerable pragmatism by only prohibiting them from smoking in public but explicitly allowing them to buy tobacco products.23 This indicates a minimalist approach to enforcement, limited to what can be easily controlled. Furthermore, even when national laws were enacted, they were seldom enforced, such as the ban on smoking in trains.3
Moreover, many possible actions were not taken. For example, there was no Reich-wide media campaign against smoking, and while the content of tobacco advertisements was restricted in December 1941,3 advertisements were not banned. Interestingly, tobacco advertising in the mass media (e.g. Das Schwarze Korps, Der Stürmer) only ceased in mid June 1942,24 apparently because the party no longer wished to draw attention to the developing shortage of consumer goods.
This ambivalent approach to tobacco control policy reflected tensions within the Nazi hierarchy. While some senior representatives of the party were in favour of a wide-ranging media campaign (e.g. Reich Health Leader Leonoardo Conti, who established a Reich Bureau Against the Dangers of Alcohol and Tobacco), others were against it. Moreover, the continued presence of tobacco advertising in the press, non-compliance by doctors and continued public smoking by high-ranking party members also made it difficult.3,25 Indeed, despite the view that smoking was unfeminine, some highly placed women, such as Eva Braun and Magda Goebbels, continued to smoke.21 Others were worried about the impact on civilian morale should key workers, such as miners and armaments workers, not get the tobacco they demanded.3
As noted above, the city of Jena in Thuringia had been a centre of opposition to smoking. On 5 April 1941, the Scientific Institute for the Research into the Hazards of Tobacco was founded in Jena; the first of its kind worldwide. The research undertaken was clearly linked to Nazi ideology.26 It was headed by Karl Astel, a high-ranking SS officer, known racial hygienist and early associate of Hitler. Astel implemented the nation’s first (modern) university tobacco ban.6 Fritz Sauckel, the administrative chief (Gauleiter) of Thuringia, one of the most devout disciples of Hitler (and also Plenipotentiary-General for Work Action, responsible for millions of deportations and the establishment of the concentration camp Buchenwald), was known for his extreme anti-tobacco measures.
The documents obtained by the authors suggest that Thuringia was not typical of the Third Reich. In 1941, Sauckel and Reichsorganisationsleiter Dr Robert Ley, also from Thuringia, pressed for an extension of the actions being taken there to the rest of Germany. A short series of meetings at the highest political level followed in May of that year to discuss the scope for a national anti-smoking campaign but these ended after 2 weeks. Minutes of these meetings provide important insights into the thinking among senior Nazis, so a chronological summary is reported in Box 1. In brief, Goebbels, Reichsminister for Propaganda and National Enlightenment, blocked calls for a comprehensive media campaign against smoking, arguing that should a campaign be undertaken, it should at least be delayed until after the war; ‘when tobacco products are no longer delivered free of cost to the individual soldier – and today these are many millions’.25
Thus, on 5 July 1941, an urgent letter was sent by telex from the Reich Propaganda Office (in agreement with the Party Chancellery) to all chief administrators of districts, members of the National Socialist Organization for Propaganda and People's Enlightenment, and liaison officers in important organizations, establishing guidelines on Reich-consistent anti-tobacco propaganda. These guidelines, which demonstrate a somewhat tolerant view of smoking, were summarized in nine bullet points25 (Box 2).
This letter was also addressed to the German Alliance for Combating the Dangers of Tobacco (Deutscher Bund zur Bekämpfung der Tabakgefahren), founded after the Nazis came to power. It specified that proposals to use the press for anti-smoking campaigns, to ban women from smoking in restaurants, and to restrict tobacco adverts to statements of manufacturer, brand name and price were not approved by the party. However, it also noted that ‘if the Alliance wishes to be consistent with existing Reich anti-tobacco propaganda’, it could do ‘valuable educational work’.25
There is no record of any anti-smoking campaign being mentioned in Reich press conferences,27 which also served as a forum for distributing orders to district offices and the press. On the contrary, an order from 25 July 1941 (daily parole number 757) states unequivocally that ‘the question of smoking or not smoking is no issue to be discussed’.28 Here it should be noted that although there is no complete documentation of the (daily) Reich Press Conferences organized by the Propaganda Ministry because of an official prohibition on taking notes, key conclusions of these conferences were summarized by officials of the Propaganda Ministry and distributed in the form of orders to district propaganda offices and the press (as far as permitted). The major newspapers had their own representatives at the conferences and thus obtained the information directly. Smaller newspapers had to be content with a short summary, the so-called daily paroles (Tagesparolen).27,28 Every day, between 150 and 250 journalists took part in these conferences (H. Gallhuber, personal communication).
Thuringia and other local actions
Interestingly, only Thuringia, with its tobacco research institute in Jena, was explicitly excluded from these regulations, being subject to special provisions. However, while there was political support for the tobacco research centre, and the more extreme measures in Thuringia (see above) were not criticized, neither Hitler nor Goebbels was willing to extend these measures to other parts of the Reich; instead it was tolerated as a ‘test case’.25
For example, women in Thuringia aged under 25 years were not allowed to smoke in restaurants. In contrast, a similar poster in the region of Emscher-Lippe (Northern Ruhr Basin) in 1941 instructing the restaurant owner to forbid women to smoke, even to ‘make use of his domestic authority’, was criticized for not being approved by any district office (Gaudienststelle). Together with other examples of ‘bad propaganda’, it was brought to the attention of the Health Minister responsible for Reich-wide regulation.25
In some parts of Germany, there were a number of unapproved anti-tobacco activities (e.g. a poster in Mecklenburg announced that the Führer deplored smoking and smokers damaged the power of the German people) as well as statements by certain individuals (e.g. Robert Ley, head of the German Labour Front, who had trained in chemistry at Jena) or organizations (e.g. German Women’s Alliance for Alcohol Free Culture – Deutscher Frauenbund für alkoholfreie Kultur, etc.).25 These were viewed as unhelpful to the party.29
Many of these local initiatives were often so exceptional that they attracted widespread media attention. Thus, a prohibition of smoking in public by boys and girls in Mecklenburg, with breaches punished by 2 weeks in prison or a fine of 150 Reichsmark, was even reported in the British ‘Daily Telegraph’ newspaper on 1 June 1936. Again, many initiatives had more to do with the status of women than with smoking as such. For example, members of the police force in the town of Erfurt were instructed to remind women smoking in public of their duties as German women and mothers, which echoed the verbal abuse of women in Berlin who wore cosmetics.22 These measures were not endorsed by the Nazi leadership and were only local actions.
Volksgesundheit, Gesundheitspflicht and guidelines on health behaviour
It is necessary to consider the role of anti-smoking activities within the broader context of ‘population health’ (Volksgesundheit) and one’s ‘duty to be healthy’ (Gesundheitspflicht), emphasized in Nazi propaganda. However, this concept primarily emphasized physical fitness, leading to the enforced assimilation of all gymnastic and sports clubs, regardless of their initial political affiliation, into Nazi organizations.
Insights can be gained from Nazi guidelines on health behaviour. While some, such as those disseminated by the Jena institute,6 focused on the hazards of smoking, where smoking is mentioned in others published by party organizations, it is usually in relation to women or young people. For example, a 1939 regulation on health education for Hitler Youth warns against the consumption of the two ‘toxins of pleasure’ (Genussgifte), tobacco and alcohol, which were incompatible with healthy physical training. Tobacco is described as adversely affecting certain parts of the brain related to willpower and decision-making, leading to mood swings, and it is suggested that the effects on the nervous system would be particularly harmful to young people. It also referred to the danger of addiction, especially among young people. Finally, it notes an effect on physical performance: ‘As tobacco is the most dangerous toxin for the circulatory system, it is avoided by all athletes’, and would be altogether ‘unmanly’.30 In another booklet targeted at young people in 1937, tobacco is not mentioned specifically; instead, it refers to ‘toxins of pleasure’ alongside several other lifestyle factors.31
Further contradictions in policy
It is important to note a number of other fundamental contradictions in the Nazi approach to smoking. Throughout the Nazi era, tobacco provided an important source of government revenue. By 1941, tobacco taxes ‘constituted about a twelfth’ (sic) of the Government’s entire income. Hundreds of thousands of Germans were said to owe their livelihood, directly or indirectly, to tobacco’.3 Until 1933, Ernst Röhm’s Sturmabteilung (storm troopers, SA) was selling its own brand of cigarette (Sturm cigarettes, manufactured by Trommler in Dresden) to raise much-needed cash. SA men were expected to smoke Sturm cigarettes alone.3
Hermann Göring (commander of the Luftwaffe) and other high-ranking Nazi officials were smokers and often smoked in public. Indeed, this was frequently mentioned in the political debate mentioned above and seen as a major obstacle to any national anti-smoking campaign.3,25 Tobacco and alcohol were advertised in Nazi publications (particularly party newspapers such as the Völkischer Beobachter and the Illustrierter Beobachter, which were published by the Nazi Party until about mid June 1942 (K. Lankheit, personal communication).
Pragmatism was also seen in relations between the party and the tobacco industry. One company, Reemtsma, had grown rapidly during the 1920s to control about two-thirds of the cigarette market. Proctor describes how it was initially subjected to sustained attacks by Nazis, including violence against those selling its products, for a variety of reasons unrelated to concerns about health.3 These included its dominant status, its competition with the SA’s Sturm cigarettes, its refusal to advertise in Nazi newspapers, and the fact that one member of its board was Jewish. However, a meeting between Phillip Reemtsa and Hermann Göring led to a rapprochement, undoubtedly facilitated by Reemtsa’s very generous support for Göring’s favourite arts projects, reported after the war, estimated to amount to over 7 million Reichmark.
Tobacco (and alcohol) were treated as luxury goods; the more privileged one was, the more goods one received, while the poorer and stigmatized got less (or nothing at all). Indeed, at celebratory events, such as the conferment of a Nazi honour, gifts in the form of spirits or tobacco products were usually given (H. Gallhuber, personal communication).
Probably the greatest contradiction was that the Volksgesundheit and Gesundheitspflicht policies (see above) were accompanied by policies that actively distributed cigarettes to ‘deserving’ groups, such as frontline soldiers. Even 17-year-old air-raid observers (Meldegänger) and anti-aircraft artillery crew (Flakhelfer), as members of the Hitler Youth, were paid partly in cigarettes,22 while ‘undeserving’ and stigmatized groups such as Jews or war prisoners (especially Russians) were denied access to tobacco.
Similarly, in times of war with most men on the front, working women were deemed too important to be denied cigarettes (some women working in arms factories, for example, were also privileged with special cigarette rations), and the party therefore cautioned against any vehement campaigns against female smoking.
International norms
It is necessary to consider the situation in Nazi Germany in the context of prevailing international norms. In most countries at that time, smoking in the street was considered ‘bad manners’, particularly for women. ‘Good manners’ were expected from those who should set a ‘good example’, such as teachers or members of the armed forces. This explains the 1939 ban on smoking by the armed forces when on the streets,1 issued by Göring who himself remained a heavy smoker, often smoking in public as outlined above.
Impact of tobacco control measures
So what impact did these tobacco control measures have? One of the key sources of information on everyday life under Nazi rule is Richard Grunberger, an Austrian Jew who survived by escaping in the kindertransport to England. His ‘Social history of the Third Reich’22 reports how cigarette and cigar consumption doubled in the Reich between 1932 and 1938. He noted how the economic upturn associated with the Nazi Government led to an ‘increased weakness’ for drinking, smoking and entertainment. This is confirmed by Proctor, who also ascribes the dramatic increase in tobacco consumption in this period to the post-1933 economic boom that ‘boosted the average German’s purchasing power’, accompanied by aggressive advertising campaigns by the tobacco industry, often employing athletic and sexual imagery, to encourage smoking.3
Grunberger describes how the onset of war accelerated this trend. Although taxes on tobacco products increased, soldiers at the front were given tobacco rations, others engaged in military service were paid in part with cigarettes, and smoking rates rose among the increasing numbers of women working in stressful factory conditions.22 German tobacco consumption did not begin to decline until 1942, when consumption peaked at 80 billion cigarettes. Then, tobacco rationing was introduced as part of wartime austerity measures while bombing raids began to reduce stores of cigarettes (as in Cologne). A 1944 survey reported that although more people were now smoking, overall tobacco consumption had decreased.3 In 1944, the tobacco industry’s research institute in Forchheim (another institute was in Vienna, Austria) issued a booklet advocating the growing of tobacco in gardens for personal and commercial use.3
Discussion
While Nazi Germany did have policies on smoking that were in advance of those in other countries, such as an age limit of 18 years for smoking, partial advertising restrictions and bans on smoking in some public places, these built on policies that existed before the Nazis came to power. These restrictions did not always represent a concern for health. For example, some were designed primarily to prevent fires and others reflected social norms concerning ‘respectable’ behaviour. Furthermore, the few national anti-smoking policies that were enacted were often poorly enforced. If the Nazi party at the highest levels had really wanted to stop people from smoking, there would have been anti-smoking campaigns originating at the top levels of the party or the Reich. However, while there were certainly a few local examples of persecution of smokers, Reich-wide campaigns cannot be identified in the official documents and party newspapers. Instead, whatever health concerns or goals there may have been inside the Health Ministry were compromised by political realities. Moreover, calls for stronger measures by the Health Ministry, including propaganda, were resisted or even forbidden by the Propaganda Ministry.
Although, as documented above, there was some political discussion about Reich-wide anti-tobacco propaganda in mid 1941, it was soon dismissed due to more immediate concerns during the war and fears that it would provoke irritation in the population. In particular, it was noted that there was a contradiction between condemning smoking while continuing to advertise cigarettes, and there was no willingness to confront this contradiction. The situation was complicated further as some high-ranking party officials smoked publicly, while many physicians were themselves smokers and played down the harms of smoking. The discussion did give rise to some guidelines, circulated as a matter of urgency to stop exaggerated measures in some parts of the Reich, but these mainly cautioned against ‘extremist’ antismoking campaigns, making clear that all propaganda activities had to be officially approved beforehand. These guidelines did not include any attempt to reduce smoking prevalence among the population, but only a very cautious attempt to influence the smoking behaviour of women and young people through their respective organizations. In the case of young people, only a few suggestions not to smoke were found in guidelines for young people published by party organizations.
Rationing of tobacco by means of coupons, which were issued by economic offices, was postponed as long as possible and was later justified as being in the interest of smokers (to prevent non-smokers from obtaining the scarce tobacco reserves). Members of the armed forces had priority in relation to rations. There were also tobacco rations for women, and members of the Hitler Youth, who were involved in military service, were partly paid with cigarettes. Even at the height of the war, the attention of the national-socialist leadership was focused on morale on the home front, fearing hostile reactions from a population that was facing a shortage of basic consumer goods.32
While health-promoting activities directed at young people throughout the Reich certainly involved widespread sports and physical training, smoking was never a major issue in youth organizations, and no rigorous anti-smoking campaign was undertaken within the Hitler Youth movement or the wider population. Thus, although tobacco research institutes and anti-smoking groups were very active, producing numerous publications in Germany, smoking was not a consistent core element of Nazi ideology, even though these organizations may have been ideologically linked to or supported by the party. The slogans and activities of these organizations were often considered extreme by senior Nazi officials, eventually leading to regulations to control them in 1941. Anti-smoking groups and individuals could only act in very limited circumstances, such as forbidding smoking in specific facilities. Measures to be taken almost always needed official approval from the propaganda offices. The exceptions, as in Thuringia, were tolerated by officials, often for personal reasons.
The picture painted in this paper does not, in any way, contradict earlier writers on this topic. Davey Smith et al. concentrated primarily on the situation in Thuringia, where there was a strong anti-smoking movement.1 Proctor described the differing views within the Nazi regime and cautioned against ‘playing the Nazi card’.3 Lewy described a number of other contradictions in Nazi rhetoric and reality.11 What this paper has been able to do, particularly through the account of discussions within the Reich Propaganda Department, is provide additional insights into the differing views within the Nazi hierarchy, and indeed how measures were taken to constrain what were seen as the excesses of the anti-tobacco lobby. Furthermore, as will be shown in a subsequent paper, the Nazi authorities in Austria were even more tolerant. In conclusion, the widespread use of Nazi imagery by pro-smoking groups to attack those seeking to limit the harm caused by tobacco is a distortion of history that cannot be justified.
Acknowledgements
The authors would like to thank the Austrian law historian, Dr Heinrich Gallhuber, for his expertise and his help in finding the respective Reich laws and ordinances, Dr Klaus Lankheit from the archive of the Institute for Contemporary History in Munich for his research and expertise, and Dr Norbert Hirschhorn, Professor George Davey Smith, Professor David Simpson and Dr Thilo Grüning for helpful comments on an earlier draft.
Ethical approval: Not required.
Funding: AG is supported by a Health Foundation Clinician Scientist Fellowship. MM and AG’s work on tobacco control is supported by grants from the US National Cancer Institute No CA 91021-01, Cancer Research UK and the Wellcome Trust.
Competing interests: None declared.
Footnotes
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