Former FDA chair talks about fighting the good fight

The man who sparked the fire that seems to be slowly burning down the nation’s tobacco industry shared his story with an audience at the ARCO Forum of Public Affairs on Monday night, April 16.

David Kessler, chairman of the U.S. Food and Drug Administration from 1990 to 1996 and now Dean of the Yale University School of Medicine, conducted an interactive guided tour of his eight-year campaign to regulate tobacco as a drug.

The presentation culminated with a brief video clip of the recent surprising admission by a top tobacco executive that some government regulation of the industry will eventually be necessary.

“Sometimes what seems to be impossible at first turns out to be something very different,” Kessler stated.

Indeed, the early days of Kessler’s crusade against the tobacco industry looked bleak, he told the audience, but the momentum began to shift with the discovery that cigarette makers had been deliberately manipulating nicotine levels in their products for years. The smoking gun, however, didn’t come until late in the fight, Kessler explained, when several “secret documents” surfaced indicating that the industry had been furtively marketing its cigarettes to teenagers.

“If you can get a young person to the age of 19, 20, or 21 [without smoking] it is unlikely that they will ever begin,” he said. “People don’t begin, at the most part, smoking at 22, 23, and 24. Nicotine addiction begins as a pediatric disease.”

Once the cigarette makers faced the prospect of losing out on the next generation of smokers, Kessler said, they realized the battle was over.

“We were aiming at the heart of the industry,” he continued. “We didn’t know that [at the time] but the fact is we were aimed at their defense because it’s not adults that start to smoke. It’s children that start to smoke, and they not only start to smoke but they become addicted as children. That’s why this started unraveling, and Phillip Morris knew that before we did.”

How best to regulate tobacco now seems to be the next challenge for the government, Kessler stated. One possible option is a deal allowing cigarette makers to “spin off” their tobacco divisions to a private, not-for-profit agency.

“Prohibition will not work,” he said, “but if we can continue to make [cigarettes] available without a big profit incentive, I think that in the end that makes the most sense, and I would give [industry officials] immunity for that.”

But even if the industry is eventually regulated in the United States, Kessler believes the world market will remain a fertile one for the tobacco industry. “We went to Macedonia recently,” he said, “and the first sign that I saw [getting off the plane] was ‘Welcome to Marlboro Country.’”

This story first appeared on the Kennedy School of Government Web site: http://www.ksg.harvard.edu