Friday, May 28 , 1999
Thank you David for accepting our " rendez-vous ". May I ask you to introduce yourself ?
My name is Dr. David Kessler, co-chair of the Coalition for World No
Tobacco Day. From 1990 through 1997, I served as Commissioner of the
United States Food and Drug Administration.
Since July 1997, I've held the position of Dean at Yale University School of Medicine.
1. You are co-chair of the coalition for World No
Tobacco Day. You said there is no quick fix for tobacco control. How do
you conceive the role of such a "day"?
How does it translate into a sustainable effort?
World No Tobacco Day is the only global event dedicated to bringing the public attention to the benefits of reducing tobacco use, focusing both on preventing young people from starting and helping current smokers to quit.
In the United States, World No Tobacco Day is sponsored by a broad coalition of non-profit public health organizations and corporate sponsors dedicated to reducing the use and harm caused by tobacco. World No Tobacco Day will be sustained by the support of a wide array of organizations.
The efforts of the World Health Organization and its member organization, the Pan American Health Organization, have already given the event strong recognition in other countries.
2. Looking now at the US web site (www.wntd.com) WNTD still seems
pretty much a US affair. You insisted on the responsibility of the US
in the world tobacco epidemic.
Do you intend to promote international actions as well as US based initiatives like the new public service ads?
The initial efforts of the Coalition for World No Tobacco Day will be focused on the U.S., recognizing the role of this country as a leader in public health.
We have a special responsibility as public health leaders because images like the Marlboro man are viewed as the product of American corporations.
If we're able to successfully reduce the number of young people who do not begin to smoke in this country, as well as continuing to reduce the number of people who quit, we can serve as a positive role model for other world efforts.
3. As a former FDA Commissioner you probably agree with Dr Brundtland's stand that cigarettes should be regulated like other nicotine delivery drugs. Do you think such a perspective is still a possibility in the US?
Yes, the U.S. Supreme Court has agreed to review the decisions of lower courts on whether or not the FDA has the authority to regulate nicotine as a drug.
They are likely to hear arguments in the fall and reach a decision no later than June 2000.
Even if the Supreme Court rules that current law does not give FDA such authority, Congress has the ability to amend the existing legislation to grant such authority.
4. The Canadian Anti-tobacco coalition proposed a whole new set of package regulations: full colored pictured warnings outside and inside the pack, a toll-free quitline number as well as an information web site. Should such regulation be considered in the US?
Yes, we certainly know that the pack of cigarettes is viewed as a "badge" among adolescents who smoke.
Carrying that pack, in the minds of teenagers, helps define how they view themselves and who they are.
While altering the imagery and appeal of the product itself is a good idea, it certainly should be part of a comprehensive array of steps to reduce the brand image that the tobacco industry has created over the last century.
5. What is your personal assessment, as of today, of the Attorney
General's settlement and what do you think should now be the priorities
for the tobacco control movement in the US?
In your new capacity at Yale, do you foresee a growing involvement of the universities?
The Attorney's General settlement was one important step in the broader tobacco control movement.
It settled the cases the Attorney's General brought against the tobacco companies for reimbursement to the Medicaid program, which provides health coverage to lower income citizens.
In some ways, the Medicaid settlement is only the tip of the iceberg.
The tobacco companies had hoped to be granted immunity from other potential civil actions, but such protections were successfully blocked from being granted.
The result is that tobacco companies ended up paying over $245 billion and got very little in return.
Obviously the most important aspect of this settlement is that the $245 billion will be raised by increasing the price of cigarettes and that price increase reduces by 8-10% the number of people who will smoke, not an insignificant percentage.
We need to recognize that the history of the tobacco control movement is really a gradual process. There is no one action or set of actions that will alone dramatically reduce the number of young people who smoke.
It will be the result of decades of action on both the grassroots and national level, on a whole host of fronts, with the end goal being a comprehensive effort of tobacco control.
We all recognize that education is key, and the at-risk ages seem to be between 6th and 9th grade.
By the 10th and 11th grades, teens who smoke are likely already addicted and are desperately in need of help to quit.
The real focus of prevention has to be education of 9 to 14 year olds.
Do you have anything else you would like to add?
I believe the world in which the tobacco companies operated is beginning to change.
No longer can they credibly claim nicotine is not addictive or that nicotine is a natural component of cigarettes.
They cannot continue to argue that smoking is simply a matter of adult choice, for we know it is children and adolescents who experiment and become addicted during these years.
The last number of years has resulted in a incredible turn around in how the tobacco companies are viewed.
They have changed from an industry that never lost a case to one with almost limitless liability.
There is also an increasing focus on tobacco control by governments throughout the world. While the tide is certainly turning, much remains to be done.
That is the reason why days like World No Tobacco Day are so important.
Thank you David for taking the time to be with us today.
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