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Thilo Grüning, MD, MSc, DEAA, Anna B. Gilmore, MBBS, MSc, MFPH and Martin McKee, MD, FRCP

At the time of the study, Thilo Grüning was with the Department of Anaesthesia and Intensive Care, Royal Free Hospital, Royal Free Hampstead NHS Trust, London, England. Anna B. Gilmore and Martin McKee are with the European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London.

Correspondence: Requests for reprints should be sent to Thilo Grüning, MD, MSc, DEAA, c/o European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, England (e-mail: t{at}gzzz.freeserve.co.uk).

Using tobacco industry documents, we examined how and why the tobacco industry sought to influence science and scientists in Germany as a possible factor in explaining the German opposition to stricter tobacco regulation.

Smoking and health research programs were organized both separately by individual tobacco companies and jointly through their German trade organization. An extensive network of scientists and scientific institutions with tobacco industry links was developed. Science was distorted in 5 ways: suppression, dilution, distraction, concealment, and manipulation.

The extent of tobacco industry influence over the scientific establishment in Germany is profound. The industry introduced serious bias that probably influenced scientific and public opinion in Germany. This influence likely undermined efforts to control tobacco use.

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