Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

C. Everett Koop’s fearless fight against the tobacco industry

Nigel Cameron, PhD
Policy
March 29, 2025
Share
Tweet
Share

An excerpt from Dr. Koop: The Many Lives of the Surgeon General.

“I have learned that, when an idea’s time has come—and it is on your watch—you must seize the moment.”
– CEK, Glasgow speech

It would take C. Everett Koop, M.D., Sc.D., just an hour—one very well-prepared hour—to overturn nine months of obloquy and ridicule. In the process, he re-ordered the public face of the Public Health Service, setting the surgeon general head and shoulders above his boss, the man supposed to have the real power, assistant secretary for health, Edward Newman Brandt Jr., who months before had dismissed the surgeon general’s office as an anachronism ripe for abolition.

In the process, Koop also shattered the easy assumption of Big Tobacco that the favored nominee of smokers’ patron saint Jesse Helms—an old-time conservative, bearded, former pipe-smoker—would prove a milquetoast.

To the savvy and the savaged, the morning editions of The Times and The Post on February 23 made it unambiguously clear. The Times devoted the top left-hand corner of its front page to a picture of the man it had lately deemed “Dr. Unqualified,” declaring smoking “society’s chief cause of preventable death.” (It is paragraph three before we read a reference to “his superior, Dr. Edward Brandt Jr.”) The Post led with the announcement that smoking is now linked to additional cancers. (In this case, Brandt would have to wait until paragraph six before he found his name, after six consecutive references to the surgeon general.)

As planned, Koop had stolen the show. He ended by saying: “Fifty-three million adults in this country still smoke cigarettes, and young people are still taking up the habit. On the evidence of the report we submit to you today, this can only presage human tragedy in the years ahead and enormous economic loss to our country.”

“If you ever saw a press conference where someone really knew their shit, that was the press conference.” Thus, Donald Shopland, longtime U.S. government tobacco control expert and author/editor of the document, on Koop’s first presentation of the annual Surgeon General’s report on smoking, February 22, 1982, just three months after his confirmation.

Brandt got to open the event and to introduce Koop to play what Mike Stobbe, historian of the surgeon general’s office, terms “his assigned bit part.” With his bulky presence and booming voice, Koop immediately dominated the proceedings. After nearly forty years of surgeon general reports, this one was “the most serious.” And, he added, “Our choice of cancer as a subject of this report should not distract attention from the even larger costs of cigarette smoking, which become apparent when deaths from coronary heart disease, chronic lung disease, and other diseases and conditions are taken into account.” Smoking kills 340,000 Americans every year.

The Tobacco Institute, the industry mouthpiece, pushed back with its increasingly risible claim that “the question is still open” whether smoking causes cancer. Koop dismissed them out of hand. “The evidence is strong and scientific, and we stand by it,” according to The Times’ front-page account.

In an hour, Koop had palpably altered the relationship between the U.S. government and one of America’s most important industries. “What had settled into a gentlemanly enmity was kicked into an all-out war,” according to one observer. “I never withheld any of the venom that I had for the cigarette companies.” Koop learned to despise the industry and to convey his contempt whenever he addressed the issue. “The thing that impelled me,” he later said, “was the sleaze with which the tobacco industry foisted their products upon an unsuspecting people with unfair advertising.”

Koop had been working for months on how to turn around the image the press had built of him during the anguished process of confirmation. He had come to the conclusion that the tobacco report provided him with that opportunity. “I think I saw smoking as the most visible thing my predecessors had done, and if I wanted to have some kind of platform from whence to jump to other things, I better do that one well.” It was a popular “apple pie” issue because tobacco consumption was already on the decline, and while the industry was powerful, smokers were not a well-organized interest group. “This was a topic on which he could establish himself as a person to be reckoned with and to do—at least what others considered—the unexpected.”

February 22, 1982, would mark the turning point. “It was the beginning of a long and increasingly warm relationship between me and the press…their point of view was changed.”

To put it another way, just ninety-seven days after being sworn in as the 13th U.S. surgeon general, Koop had his bully pulpit.

ADVERTISEMENT

Nigel Cameron is a historian and ethicist whose work has spanned the disciplines of bioethics, history, and religion over a distinguished transatlantic academic career. He currently serves as a senior fellow at the University of Ottawa and was previously a research professor of bioethics at the Illinois Institute of Technology in Chicago, where he led pioneering projects on the social and ethical impact of emerging technologies and on diabetes policy. A former Fulbright visiting research chair at the University of Ottawa’s Institute for Science, Society and Policy, he continues to explore the intersection of medicine, ethics, and public policy.

Dr. Cameron was the founding editor of the journal Ethics and Medicine and has served as a hospital consulting ethicist. He has held board roles with UK think tanks 2020health.org and BioCentre, and has testified before committees of the U.S. Congress and the European Union. He has also represented the United States in diplomatic delegations to United Nations health-related agencies and was nominated by the U.S. government to serve as UN Special Rapporteur for the Right to Health.

His books include Dr. Koop: The Many Lives of the Surgeon General, Will Robots Take Your Job? A Plea for Consensus, and The New Medicine: Life and Death After Hippocrates. His current project, Ruth: The Psychiatrist Who Saved Sylvia Plath, Until She Couldn’t, continues his exploration of complex figures in medicine.

For more about his work, visit drkoop.bio, or connect with him on Facebook and LinkedIn.

Prev

Flying with food allergies: Combating misconceptions and advocating for safety

March 29, 2025 Kevin 0
…
Next

How diversity transforms health care and patient outcomes [PODCAST]

March 29, 2025 Kevin 1
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Flying with food allergies: Combating misconceptions and advocating for safety
Next Post >
How diversity transforms health care and patient outcomes [PODCAST]

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Nigel Cameron, PhD

  • How DrKoop.com rose and fell: the untold story behind the Surgeon General’s startup

    Nigel Cameron, PhD
  • C. Everett Koop takes the lead, seeking specialty recognition

    Nigel Cameron, PhD
  • C. Everett Koop meets the giants of pediatric surgery: Ladd and Gross

    Nigel Cameron, PhD

Related Posts

  • The locums industry has a beef problem

    Aaron Morgenstein, MD
  • Tobacco’s time warp: How centuries of smoke obscured our future

    Sammer Marzouk, Cameron Sabet, and Ketan Tamirisa
  • Murder, vitriol, and hidden costs: inside the health insurance industry’s biggest battles

    Lynne Moronski, PhD, MPA, RN
  • Why the health care industry must prioritize health equity

    George T. Mathew, MD, MBA
  • The deadly impact of the U.S. anti-abortion funding policy

    Analisa Conway and Ashley Gordon
  • Take politics out of science and medicine

    Anonymous

More in Policy

  • The lab behind the lens: Equity begins with diagnosis

    Michael Misialek, MD
  • Conflicts of interest are eroding trust in U.S. health agencies

    Martha Rosenberg
  • When America sneezes, the world catches a cold: Trump’s freeze on HIV/AIDS funding

    Koketso Masenya
  • A surgeon’s late-night crisis reveals the cost confusion in health care

    Christine Ward, MD
  • The school cafeteria could save American medicine

    Scarlett Saitta
  • Native communities deserve better: the truth about Pine Ridge health care

    Kaitlin E. Kelly
  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
  • Recent Posts

    • Why personal responsibility is not enough in the fight against nicotine addiction

      Travis Douglass, MD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Alzheimer’s and the family: Opening the conversation with children [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI in mental health: a new frontier for therapy and support

      Tim Rubin, PsyD | Conditions
    • What prostate cancer taught this physician about being a patient

      Francisco M. Torres, MD | Conditions
    • Why fearing AI is really about fearing ourselves

      Bhargav Raman, MD, MBA | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
  • Recent Posts

    • Why personal responsibility is not enough in the fight against nicotine addiction

      Travis Douglass, MD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Alzheimer’s and the family: Opening the conversation with children [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI in mental health: a new frontier for therapy and support

      Tim Rubin, PsyD | Conditions
    • What prostate cancer taught this physician about being a patient

      Francisco M. Torres, MD | Conditions
    • Why fearing AI is really about fearing ourselves

      Bhargav Raman, MD, MBA | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...