A Question of Intent: How the FDA Finally Took on Tobacco and Won Book

This is the David-and-Goliath story of how an American bureaucrat took on the tobacco industry--and helped topple it. David Kessler, head of the Food and Drug Administration for seven years under Presidents Bush and Clinton, earned the nickname "Eliot Knessler" from The Washington Post--a pun meant to evoke the memory of the Prohibition-era gangbuster--because he rejuvenated a moribund agency. The FDA regulated, in Kessler's words, "one quarter of every dollar Americans spent--from the food they eat to the drugs they take to the cosmetics they wear." Yet it lacked the courage to take on the country's most lethal product: cigarettes. So did Kessler, at least initially. He agreed with aides and others that Big Tobacco was too powerful a force in Washington, D.C. "The industry perceived threats everywhere, and responded to them ferociously," he writes. Moreover, challenging the industry would waste important resources that could have a more tangible benefit for consumers if they were spent elsewhere. Even before making the choice to go after cigarettes, Kessler was a figure of controversy, and this only intensified when he became one of the few Republican holdovers in the Clinton administration. Much of the book deals with the routine business of the FDA: orange-juice seizures, a fight to restrict the sale of body tissues from foreign sources, how he responded to complaints that syringes were found in Pepsi cans, and so on. But the driving force behind Kessler's narrative is how he slowly woke up to the possibility of regulating cigarettes. "It is too easy to be swayed by the argument that tobacco is a legal product and should be treated like any other," he writes. "A product that kills people--when used as intended--is different. No one should be allowed to make a profit from that." His story is a lesson in Washington power politics--a game he played with naiveté when he started but was expert at by the end of his tenure. To say Kessler and his team of FDA regulators "defeated" Big Tobacco is an overstatement: they were part of a broader effort that included trial lawyers, consumer groups, and crusading journalists, and the industry hasn't exactly gone away. But they were instrumental in forcing tobacco companies to admit that nicotine is addictive and cigarettes cause cancer, and in bringing about a sea change in the industry's legal and popular standing. Kessler now believes in regulation so tight it will strangle Big Tobacco forever: "If our goal is to halt this manmade epidemic," he writes, "the tobacco industry, as currently configured, needs to be dismantled." A Question of Intent is a well-told muckraker. It unfolds deliberately, like a good detective story. Admirers of Jonathan Harr's A Civil Action, especially those with a taste for public policy, won't be disappointed. --John J. Miller Read More