A Question of Intent : A Great American Battle With A Deadly Industry [Hardcover]

David A. Kessler (Author)

Book Description

Publication Date: January 9, 2001

From the controversial former FDA commissioner: the surprisingly gripping, suspenseful, inside story of how the FDA confronted the tobacco industry.. Tobacco companies had been protecting their turf for decades. They had congressmen in their pocket. They had corrupt scientists who made excuses about nicotine, cancer and addiction. They had hordes of lawyers to threaten anyone--inside the industry or out--who posed a problem. They had a whole lot of money to spend. And they were good at getting people to do what they wanted them to do. After all, they had already convinced millions of Americans to take up an addictive, unhealthy, and potentially deadly habit.David Kessler didn't care about all that. In this book he tells for the first time the thrilling detective story of how the underdog FDA--while safeguarding the nation's food, drugs, and blood supply--finally decided to take on one of the world's most powerful opponents, and how it won. Like A Civil Action or And the Band Played On, A Question of Intent weaves together science, law, and fascinating characters to tell an important and often unexpectedly moving story. We follow Kessler's team of investigators as they race to find the clues that will allow the FDA to assert jurisdiction over cigarettes, while the tobacco companies and their lawyers fight back--hard. Full of insider information and drama, told with wit, and animated by its author's moral passion, A Question of Intent reads like a Grisham thriller, with one exception--everything in it is true. Tobacco companies had been protecting their turf for decades. They had congressmen in their pocket. They had corrupt scientists who made excuses about nicotine, cancer and addiction. They had hordes of lawyers to threaten anyone--inside the industry or out--who posed a problem. They had a whole lot of money to spend. And they were good at getting people to do what they wanted them to do. After all, they had already convinced millions of Americans to take up an addictive, unhealthy, and potentially deadly habit.David Kessler didn't care about all that. In this book he tells for the first time the thrilling detective story of how the underdog FDA--while safeguarding the nation's food, drugs, and blood supply--finally decided to take on one of the world's most powerful opponents, and how it won. Like A Civil Action or And the Band Played On, A Question of Intent weaves together science, law, and fascinating characters to tell an important and often unexpectedly moving story. We follow Kessler's team of investigators as they race to find the clues that will allow the FDA to assert jurisdiction over cigarettes, while the tobacco companies and their lawyers fight back--hard. Full of insider information and drama, told with wit, and animated by its author's moral passion, A Question of Intent reads like a Grisham thriller, with one exception--everything in it is true. *More detail, drama, and inside information on the whistle-blowers, investigators, and major players in the campaign against Big Tobacco A great read for anyone who likes gripping narrative nonfiction or relishes a terrific, true detective story .

Editorial Reviews

Amazon.com Review

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.

Copyright 2001 Cahners Business Information, Inc.

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Product Details

• Hardcover: 400 pages
• Publisher: PublicAffairs; 1st edition (January 9, 2001)
• Language: English
• ISBN-10: 1891620800
• ISBN-13: 978-1891620805
• Product Dimensions: 9.6 x 6.5 x 1.7 inches
• Shipping Weight: 2 pounds
• Average Customer Review: 4.6 out of 5 stars  See all reviews (38 customer reviews)
• Amazon Best Sellers Rank: #765,817 in Books (See Top 100 in Books)

More About the Author

DAVID A. KESSLER, MD, served as commissioner of the US Food and Drug Administration under presidents George H. W. Bush and Bill Clinton. He is a pediatrician and has been the dean of the medical schools at Yale and the University of California, San Francisco. A graduate of Amherst College, the University of Chicago Law School, and Harvard Medical School, Dr. Kessler is the father of two and lives with his wife in California.

Customer Reviews

Most Helpful Customer Reviews

18 of 18 people found the following review helpful:

5.0 out of 5 stars A good read or a good book for one interested in policy...., April 8, 2001

By 

J. Michael Showalter (Nashville, TN United States) - See all my reviews
(VINE VOICE)   

This review is from: A Question of Intent : A Great American Battle With A Deadly Industry (Hardcover)

It's funny that when I purchased this book, I never really suspected that it would be quite the page-turner that it is. In this book, David Kessler (former head of the FDA) speaks first of his agency's enlightenment that it COULD and SHOULD fight Big Tobacco and then of the fight itself. This is gripping and compelling a story that public policy has to offer: it's hard to remember that ten years ago, the tobacco industry still held that nicotine a)was not addictive and b)did not cause cancer; this book shows how these myths were finally put to bed in the public sphere. Second, this is a neat story. Kessler has much more of a knack for putting words down on a page than one would expect for a medical doctor (perhaps his wife, whom he declares was a fan of Anthony Trollope, rubbed off on him!) He puts together a story that is worthy of John Grisham; seeing that Erin Brockovich became one of the big pictures of the past twelve months, this fella might have something going for himself here....

Setting all of these aside, this book has something to offer for people interested in how the American political system works. In much the same way as books like 'Boomerang!' chronicled the downfall of the centrally-funded health care system also circa the early Clinton-era, this book deals with one of the great succeses (or a part thereof) of the same period. This is a great read and entirely worth buying in hardcover....

Please buy this book....

20 of 22 people found the following review helpful:

5.0 out of 5 stars Even In Government People Make The Difference, January 10, 2001

By A Customer

This review is from: A Question of Intent : A Great American Battle With A Deadly Industry (Hardcover)

This is a wonderful book that should appeal to tobacco warriors and the general public alike. It reads like a novel, yet its copiously documented throughout.. It will be equally at home on your coffee table and as required reading in graduate schools of public poicy.

Whether you agree with what David Kessler did or you don't, the message here goes far beyond tobacco. At a time when there is a feeling that government no longer matters, this book shows how a small group of people,in one government agency,led by a leader who believed deeply in the law and his cause, can make a difference..

That Kessler's tobacco war ended in defeat with a 5 to 4 vote in the Supreme Court provides an eery parallell to recent events. But no one felt good about the election mess in Florida. Most Americans, liberal or concervative, will feel pretty good when they finish this book. It shows that leadership can still make a difference and that our government can still matter.

19 of 21 people found the following review helpful:

5.0 out of 5 stars Storytelling at its best -- about something that matters, January 11, 2001

By A Customer

This review is from: A Question of Intent : A Great American Battle With A Deadly Industry (Hardcover)

A great read, one of those books that justly deserves to be called a page-turner. If any doubt remained about the character of the tobacco industry and the damage it inflicts, A Question of Intent lays it to rest. Funding volunteer firefighters who then make public statements downplaying the risk of cigarettes as a source of fire? Adding chocolate to tobacco because when burned it gives off a chemical that may make it easier to inhale? Identifying Islamic religious leaders who oppose an interpretation of the Qur'an that would lead to a ban on tobacco use? Who knew?

But this is no predictable polemic, far from it. It's more like a detective story, with shrouded informants, driven investigators, and the pursuit of long-shot leads and buried clues. David Kessler comes across as agile, self-effacing, and very smart, with a surprisingly ironic sense of humor. A Question of Intent is about more than tobacco. It is also about the education of a political neophyte and an insider's look at Washington -- that messy, unseemly place where someone with vision, commitment and wiles can still make a difference.