Drawing on his personal experience, Dr. David Kessler, the former commissioner of the Food and Drug Administration and current dean of the Yale University School of Medicine, lectured Tuesday evening about obstacles he encountered in his battles against the tobacco industry.
Speaking to a nearly full Love Auditorium, Kessler involved the audience in his presentation by describing situations he had faced and asking audience members what they would do in his shoes.
Kessler explained the first reaction he received upon telling acquaintances of his goal to take on the tobacco industry: People told him his venture would be utterly impossible and would amount to professional suicide.
"No matter who you asked you got the same answer: 'You can't do that. You can't take on the tobacco industry-they're just too powerful,'" Kessler explained.
Kessler posed specific obstacles and asked the audience how to overcome them. He raised the hotly debated and still-unsettled legal question of whether tobacco regulation falls within the scope of the FDA's responsibilities.
"We first had to prove that nicotine was a drug according to the legal definition of a drug," he said. "We had to show that nicotine was an article, other than food, intended to affect the structure or any function of the body."
He said the FDA then had to demonstrate that tobacco companies knowingly manipulated the amount of nicotine in cigarettes so people would become addicted.
He noted that proving this point was not an easy task. "Even if you prove that nicotine fits the legal definition of a drug, how can you prove that the tobacco companies are intentionally lying to the public about their products?" he asked.
Guiding the audience through the discussion, Kessler explained that the FDA discovered tobacco companies' public deception after testing the amount of nicotine in different kinds of cigarettes.
What they found, he said, was that of three grades of Philip Morris-manufactured Merit brand cigarettes-Merit, Merit Light and Merit Ultralight-Ultralights actually contained the most nicotine. He said these findings contradict companies' marketing of lighter cigarettes as those that contain the least amount of nicotine.
Kessler added that teenagers are the most susceptible to cigarettes and that tobacco companies target the age group so they become addicted early.
A lawyer and pediatrician, Kessler served as FDA commissioner from 1990 to 1997. He began considering regulating nicotine as a drug and was instrumental in convincing the Clinton administration to enact tougher federal tobacco laws.
A federal appeals court ruled last year that the FDA did not have the authority to regulate tobacco, but the Supreme Court has agreed to hear the case. A decision is expected next spring.
Audience members seemed captured by the discussion, and often participated in the open conversation.
"I thought it was very memorable and stimulating," said Elizabeth Kiss, director of the Kenan Ethics Program. "He took us through the story and got the audience engaged as he explained the process that the FDA went through in figuring out how to try to regulate tobacco."
Kessler's evening talk, "Tobacco Wars," was the inaugural Boyarsky lecture in law, medicine and ethics. He had also spoken to students earlier in the day, giving them an opportunity to ask questions in a more informal setting.
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