Kessler's Unlikely Page-Turner Tells How FDA Smoked Out Big Tobacco

Preparation of a case study on the FDA's decision to regulate tobacco

A Question of Intent: A Great American Battle with a Deadly Industry (Public Affairs Books, 2001) by David A. Kessler, former Food and Drug Administration (FDA) Commissioner, focuses on the FDA's decision to regulate tobacco products as drugs.

The regulation was issued in August 1996 and imposed new restrictions on the sale and promotion of cigarettes and smokeless tobacco to children and adolescents.

This grant supported the development and writing of the book by Dr. Kessler and a team of researchers. The grant was overseen by faculty at Yeshiva University, Albert Einstein College of Medicine, Bronx, N.Y.

Key Results

  • A Question of Intent was widely reviewed, including reviews in the New York Times Book Review, The New Yorker, Business Weekly, the Washington Post, and JAMA.

    Industry documents played a large part in proving intent. Exhaustive review of documents obtained in lawsuits against the tobacco industry revealed that for years nicotine had been known to be addictive and to function as a tranquilizer, a stimulant, or a depressant.

    Such explicit statements, previously unknown to the health community, showed that the tobacco industry was actively designing its products to deliver, in the words of a 1963 Brown and Williamson memo, "an addictive drug effective in the release of stress mechanisms."

    This compelling book ends with Dr Kessler's recommendation that the tobacco industry be reorganized to remove the profit motive from supplying this addictive, deadly product, allowing only for sales of cigarettes in plain wrappers without logos through tightly controlled outlets.