A Question Of Intent: A Great American Battle With A Deadly Industry

by David Kessler (Author)

Editorial Reviews

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

From Publishers Weekly
"My understanding of the industry's power finally forced me to see that... the
solution to the smoking problem rests with the bottom line, prohibiting the
tobacco companies from continuing to reap profits from the sale of a deadly
addictive drug.... " These strong words from Kessler, now dean of the Yale
University School of Medicine and commissioner of the U.S. Food and Drug
Administration from 1990 to 1997, testify to his commitment to regulating
tobacco, as well as to the frustration involved in taking on the powerful
tobacco industry. In understated, lucid language, he details how his interest in
smoking as a public health issue grew into a full-scale investigation into the
practices of the tobacco industry. Drawing on legal and scientific research and
the notes he kept during his terms as commissioner, Kessler documents how the
team he assembled built a case that implicated the industry in nicotine
manipulation that increased the addictiveness of cigarettes. With the assistance
of informants like Jeffrey Wigand, a former Brown and Williamson researcher and
subject of the film The Insider, the team learned about genetically altered
plants created to produce higher nicotine levels. Kessler indicts the tobacco
industry for lying to Congress and the public about these activities, denying
the strong relationship between smoking and lung cancer and launching ad
campaigns to encourage smoking, particularly among children. With the backing of
Vice-President Al Gore, the FDA issued regulations to curb smoking that were
eventually overturned by a 5-4 Supreme Court decision in early 2000. This is an
important study of the influence of big tobacco and the high cost to the public
health of the nation that smoking has caused.

Product Details

Paperback: 492 pages
Publisher: PublicAffairs; New Ed edition (March 19, 2002)
Language: English
ISBN-10: 1586481215



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