When German government point woman Marlene Mortler presented the official 2018 report on drugs and addiction in Germany, she did not stress opioids, cocaine, LSD or even cannabis. Instead, she stressed that nicotine remains the addictive drug that has cost the most lives in the country in recent years.

The numbers of people in Germany who smoke have declined by 30 percent since 2013, as they have elsewhere in Europe. But Mortler still singles out tobacco as an area where more needs to be done.

"We can't relax when we have 120,000 tobacco-related deaths every year," Mortler told reporters in Berlin. "120,000 deaths mean 120,000 cases of great suffering, and public costs of up to €100 billion ($115 billion)."

In an attempt to turn off potential puffers, Germany has required cigarettes to feature so-called "shock pictures," gruesome photographs of the diseases caused in part by smoking, on all packaging since 2016. Still roughly a quarter of all adult Germans smoke, and Mortler wants to take away incentives for them to do so, including one major form of positive advertising.

"Because we know prevention is effective, we shouldn't go only halfway," Mortler said. "That's why we need a ban on outdoor advertising for tobacco. People who smoke reduce their life expectancy by 10 years. No other legal product is so harmful no matter how it's used."

Germany is the only country in the European Union that allows outdoor tobacco advertising. Mortler, a member of the Bavarian conservative party, the CSU, already succeeded in getting the Cabinet of the previous government under Chancellor Angela Merkel to back a ban of the practice, only to see the ban torpedoed — from within her own conservative bloc.

The tobacco lobby and the CDU

So why does nutrition- and fitness-obsessed Germany still allow advertising banned in such far less health-conscious countries as Bulgaria? Money, say anti-smoking activists. The World Health Organization has called for political parties not to accept sponsorship from tobacco companies, but the major parties in Germany have not been deterred.

One man, in particular, attracts activists' ire: the former secretary-general of Merkel's conservative Christian Democrats, Volker Kauder.

"Mr. Kauder repeatedly stalled and blocked anti-smoking legislation," the chairman of the anti-smoking group Pro Rauchfrei, Siegfried Ermer, told DW. "The last time was last year when there was a ban on outdoor advertising waiting for parliamentary approval. Mr. Kauder took it off the official agenda so the issue was never addressed."

The issue was also struck from the current conservative-Social Democratic government's coalition agreement. Critics say this omission came at the behest of the Merkel confidante.

"For us, Kauder is one of the biggest lobbyists for the tobacco industry in politics," Ermer says, and the anti-corruption Lobby Control organization agrees with that assessment.

A major cigarette filter tube factory is located in Kauder's home constituency, and in response to an official query by the Left Party in March 2017, the government admitted that there had been 32 meetings between tobacco lobbyists and high-ranking government members. Kauder didn't respond to a request for a statement on Mortler's latest proposal.

Kauder recently lost a bid for re-election to his post as CDU secretary-general to Ralf Brinkmann. Could the change of personnel help Mortler's ban finally become reality?

"We hope so," says Ermer. "We hope that Mr. Brinkmann has an open mind on this score, and we've been trying to talk with Health Minister Jens Spahn for over a year now."

'It undermines all attempts at prevention'

But help from Spahn is unlikely to be immediately forthcoming. Rather astonishingly, considering smoking's effects on people's physical well-being, the health ministry has declined to take a position on Mortler's attempts, past and present, to ban some forms of advertising for it.

That's not acceptable, say the opposition Left Party and the left-leaning Greens, who have both tried to introduce legislation to curb the promotion of tobacco. The changing nature of how people consume nicotine, they argue, increases the need for government action.

"The prevention of tobacco consumption and protection of people's health has come to a standstill," Green drug policy spokeswoman Kirsten Kappert-Gonther told DW. "Outdoor advertising particularly affects young people, and the increasing consumption of e-cigarettes among youths shows that advertising for them undermines all attempts at prevention."

The issue has thus created an unusual alliance between the left and some conservatives, with Mortler's report also warning about the still largely unresearched health effects of vaping and other nontraditional forms of nicotine consumption.

The tobacco industry argues that Mortler's proposed ban would be a slippery slope leading to prohibitions on advertisements for alcohol and many other products. There is no doubt that tobacco companies place a great deal of stock in outdoor advertisement. After all, they spent more than €87 million on it in 2016. That sum dwarfs the money allocated to print and cinema ads for tobacco.

Conversely, the German government earns €14.4 billion a year from its 75 percent tax on tobacco products. That's one likely reason Germany has been so tolerant of cigarette advertising.