In a report issued late last month, a presidential commission recommended giving the Food and Drug Administration (FDA) the power to regulate tobacco in the interest of public health.
It's a cause that was long championed by former FDA commissioner David Kessler, who writes about his time in office in a new book.
David Kessler came took the helm of the FDA in 1990. He's been out for 3 years. He says taking on the tobacco industry was the most challenging aspect of his job.
"We asked a simple question. We asked the question of whether nicotine is a drug," says Kessler. "So it's a question of intent: What did the tobacco companies know? What did they intend about nicotine? And no one had ever gone to ask that question."
To try to control an industry they believed was endangering the nation's public health, Kessler and a team of FDA investigators worked with informants with code names like Deep Cough, Veritas, and Research. The informants revealed that tobacco companies had deliberately manipulated nicotine levels in cigarettes to keep smokers coming back for more.
"I underestimated the power of this industry. They have their tentacles in government, in media, and the scientific and medical communities. They had a former FDA commissioner on retainer. They got the congress to hold hearings to investigate us," says Kessler.
What began as an investigation of big tobacco turned into a crusade, with industry leaders denying any responsibility for a product scientists say kills 400,000 a year. Kessler vowed to change the way the tobacco industry did business.
The tobacco companies said, "Cigarette smoking is not addictive," and "We do not do anything to hook smokers or keep them hooked."
But Kessler says, "What the cigarette makers say is less important than what they do."
There were victories--for instance, when attorneys general from all 50 states won a landmark settlement against tobacco companies to recover public health costs.
Kessler says it was one step and began chipping away at the tobacco industry. But while that settlement also ended the Joe Camel billboard, companies still advertise in stores and in print. Programs to keep kids from taking up smoking have not been a big success. And Kessler lost his battle to get FDA control over tobacco as a drug
The Supreme Court ruled by one vote that it could not regulate the tobacco.
"One of the Supreme Court justices said nicotine is no different from a horror movie. And I'm sitting there--'What?' Nicotine is a powerful addictive drug, and the justice said, 'Well, you know, horror movies get your adrenaline pumping.' They just didn't see the fact that nicotine is a drug," says Kessler.
Kessler does not see the fight against tobacco as partisian. In 1990, he was appointed by President George Bush, and later he enjoyed President Clinton's support.
"I had sent him in the interim the results of our investigation, and he had read hundreds of pages. He had read ll the pages that I had sent him, and I was called up to the private residence," says Kessler. "I walked into his study, and he looked at me and he said, 'I want to kill them.'"
Still, the tobacco industry is far from dead. Twenty-five percent of Americans over the age of 18 smoke. But Kessler believes his investigation opened the door to endless lawsuits, which may eventually leave the industry unprofitable
"I am convinced, though, that in the end we need to dismantle this industry," says Kessler. "Prohibition will not work."
"I think we have to take the profit out of the sale of cigarettes. No one should be able to profit from the sale of an addictive drug," says Kessler.
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