in nazi germany. many people have been critical about tobacco use since it gained popularity. in 1798, dr. benjamin rush (early american physician, signer of the declaration of independence, surgeon general under george washington, and anti-tobacco activist) was "against the habitual use of tobacco" because he believed it (a) "led to a desire for strong drink," (b) "was injurious both to health and morals," (c) "is generally offensive to" nonsmokers, (d) "produces a want of respect for" nonsmokers, and (e) "always disposes to unkind and unjust behavior towards them." with the modernization of cigarette production compounded with the increased life expectancies during the 1920s, adverse health effects began to become more prevalent. in germany, anti-smoking groups, often associated with anti-liquor groups, first published advocacy against the consumption of tobacco in the journal der tabakgegner (the tobacco opponent) in 1912 and 1932. in 1929, fritz lickint of dresden, germany, published a paper containing formal statistical evidence of a lung cancer–tobacco link. during the great depression, adolf hitler condemned his earlier smoking habit as a waste of money, and later with stronger assertions. this movement was further strengthened with nazi reproductive policy as women who smoked were viewed as unsuitable to be wives and mothers in a german family. the movement in nazi germany did reach across enemy lines during the second world war, as anti-smoking groups quickly lost popular support. by the end of the second world war, american cigarette manufacturers quickly reentered the german black market. illegal smuggling of tobacco became prevalent, and leaders of the nazi anti-smoking campaign were assassinated. as part of the marshall plan, the united states shipped free tobacco to germany; with 24,000 tons in 1948 and 69,000 tons in 1949. per capita yearly cigarette consumption in post-war germany steadily rose from 460 in 1950 to 1,523 in 1963. by the end of the 20th century, anti-smoking campaigns in germany were unable to exceed the effectiveness of the nazi-era climax in the years 1939–41 and german tobacco health research was described by robert n. proctor as "muted". a lengthy study conducted in order to establish the strong association necessary for legislative action (us cigarette consumption per person blue, male lung cancer rate green) in the uk and the us, an increase in lung cancer rates, formerly "among the rarest forms of disease", was noted by the 1930s, but its cause remained unknown and even the credibility of this increase was sometimes disputed as late as 1950. for example, in connecticut, reported age-adjusted incidence rates of lung cancer among males increased 220% between 1935–39 and 1950–54. in the uk, the share of lung cancer among all cancer deaths in men increased from 1.5% in 1920 to 19.7% in 1947. nevertheless, these increases were questioned as potentially caused by increased reporting and improved methods of diagnosis. although several carcinogens were already known at the time (for example, benzopyrene was isolated from coal tar and demonstrated to be a potent carcinogen in 1933), none were known to be contained in adequate quantities in tobacco smoke. richard doll in 1950 published research in the british medical journal showing a close link between smoking and lung cancer. four years later, in 1954 the british doctors study, a study of some 40 thousand doctors over 20 years, confirmed the link, based on which the government issued advice that smoking and lung cancer rates were related. in 1964 the united states surgeon general's report on smoking and health demonstrated the relationship between smoking and cancer. further reports confirmed this link in the 1980s and concluded in 1986 that passive smoking was also harmful. as scientific evidence mounted in the 1980s, tobacco companies claimed contributory negligence as the adverse health effects were previously unknown or lacked substantial credibility. health authorities sided with these claims up until 1998, from which they reversed their position. the tobacco master settlement agreement, originally between the four largest us tobacco companies and the attorneys general of 46 states, restricted certain types of tobacco advertisement and required payments for health compensation; which later amounted to the largest civil settlement in united states history. from 1965 to 2006, rates of smoking in the united states have declined from 42% to 20.8%. a significant majority of those who quit were professional, affluent men. despite this decrease in the prevalence of consumption, the average number of cigarettes consumed per person per day increased from 22 in 1954 to 30 in 1978. this paradoxical event suggests that those who quit smoked less, while those who continued to smoke moved to smoke more light cigarettes. this trend has been paralleled by many industrialized nations as rates have either leveled-off or declined. in the developing countries, however, tobacco consumption continues to rise at 3.4% in 2002. in africa, smoking is in most areas considered to be modern, and many of the strong adverse opinions that prevail in the west receive much less attention. today russia leads as the top consumer of tobacco followed by indonesia, laos, ukraine, belarus, greece, jordan, and china. at the global scale, initial ideas of an international convention towards the prevention of tobacco had been initiated in the world health assembly (wha) in 1996. in 1998, along with the successful election of dr. gro harlem brundtland as the director-general, the world health organization set tobacco control as its leading health concern and has begun a program known as the tobacco free initiative (tfi) in order to reduce rates of consumption in the developing world. however, it was not until 2003 that the framework convention on tobacco control (fctc) was accepted in wha and entered into force in 2005. fctc marked a milestone as the first international treaty concerning a global health issue that aims to combat tobacco in multiple aspects including tobacco taxes, advertisement, trading, environmental affects, health influences, etc. the birth of this evidence-based and systematic approach has resulted in the reinforcement of tobacco taxes and the implementation of smoke-free laws in 128 countries that led to the decrease of smoking prevalence in developing nations. other substances in the early 1980s, organized international trafficking of cocaine grew. however, overproduction and tighter legal enforcement for the illegal product caused drug dealers to convert the powder to "crack" – a solid, smokable form of cocaine that could be sold in smaller quantities to more people. this trend abated in the 1990s as increased police action coupled with a robust economy caused many potential consumers to give up or fail to take up the habit. recent years shows an increase in the consumption of vaporized heroin, methamphetamine and phencyclidine (pcp). along with a smaller number of psychedelic drugs such as changa, dmt, 5-meo-dmt, and salvia divinorum. substances and equipment