Koop Speaks Against Tobacco Ruling
Thursday, March 23, 2000
Dr. C. Everett Koop responds to the U.S. Supreme Court's
decision prohibiting the Food and Drug Administration
(FDA) from regulating tobacco. Dr. Koop founded
drkoop.com in 1998 and serves as chairman of the
board. The views expressed here reflect his own beliefs
based on 8 years as U.S. Surgeon General and more
than 40 years of medical experience.
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...the tobacco industry has for years
pandered to children before they were able to make
decisions about their future. Now, as a result, we have
49 million nicotine addicts. I believe something has to
be done to curb these actions.
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Q. Obviously, the court was divided over the issue of
whether or not to let the FDA regulate tobacco. What do
you think lead them to the decision they made?
A. I think the court decided to not allow the FDA to regulate
it because the majority of the justices are strict constructionists.
It is true that Congress never specifically gave the FDA the
right to regulate tobacco, which is why it felt the FDA was
overstepping its boundaries. But I think the Court could have
satisfied its obligation as the highest court in the land without
being so cut-and-dried about what the FDA can and cannot
regulate. As constructionists, they stick to the letter of the law.
Q. How did this issue ever make it to the Supreme Court?
A. In 1996, FDA Commissioner David A. Kessler, M.D., and
President Clinton first decided that the FDA would require
stores to take measures to try to reduce cigarette sales to
young people. The tobacco industry claimed the agency
lacked the authority to do that, and sued the FDA. The FDA
lost that suit in 1998, and this case was its appeal.
Q. Explain why the FDA believes it can regulate tobacco.
A. Well, the FDA has the right to regulate food, drugs and
cosmetics, and devices that deliver these items. Nicotine
is definitely a drug -- an addictive drug -- and cigarettes
deliver this addictive drug to the user. So the FDA has two
reasons why it should be able to regulate tobacco in the
form of cigarettes.
Q. And the court disagreed with this claim?
A. Well, in its decision to not allow the FDA to regulate
tobacco, Justice Sandra Day O'Connor said that giving the
agency that right would mean the FDA would be forced to
take such a dangerous substance off the market. That was
what the tobacco industry's attorney argued, but it's simply
not true.
I wish the Supreme Court had known more about the
addiction to nicotine, as well as the activities of the Public
Health Service, of which the FDA is a part. If they had
known more, they would have also realized that the Public
Health Service would never remove tobacco from 49 million
nicotine addicts. The result of that would be a medical
catastrophe such as this country has never seen before.
The FDA has never proposed to take cigarettes off the
market, and there's no directive that says it has to. What
the Supreme Court also failed to consider is that every
drug the FDA approves is dangerous. That's why they also
require that each drug manufacturer disclose possible
dangerous side effects and interactions with other drugs.
I believe that, if the Court understood the danger of addiction,
and the fact that the Public Health Service is in the business
of taking care of people, it would have known that the Public
Health Service would never deprive 49 million Americans of
the fix that keeps them normal and sane.
Q. Now that the ball is in Congress's court, do you think the
FDA will get regulatory power over the tobacco industry?
A. Well, the reasonable expectation after the Supreme
Court's decision would be that Congress would see that
the FDA has that right. But based on what Sen. Trent Lott,
R.- Miss., said on television yesterday, I'm not optimistic.
He basically accused the FDA of not being able to do the
job it's doing now well enough, and therefore, he was
pleased that it didn't have something else added to its
load. And remember, Lott is that man who, in my opinion,
led the Republican Congress to sell out to the tobacco
industry when the McCain bill was up for vote in 1998.
That bill, led by Sen. John McCain, R.-Ariz., would have
created a special agency under the FDA specifically to
regulate tobacco. But the tobacco industry opposed it.
So, between Lott being the leader of the Republican
Senate, and this being an election year, it is very unlikely
that the FDA will get that authority.
Q. Are tobacco companies, then, bolstered or battered
by the Supreme Court's decision?
A. I think this plays right into their hands. Now Phillip Morris
says things like, "It's time for reasonable discourse about
tobacco regulation." But it's the words they use like,
"reasonable gestures" that make me think we can't trust
the tobacco industry -- they haven't earned the trust of the
American public.
Tobacco is the single most preventable cause of death
in this country. And the tobacco industry has for years
pandered to children before they were able to make
decisions about their future. Now, as a result, we have
49 million nicotine addicts. I believe something has to
be done to curb these actions.
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