FDA Chief Calls Nicotine Addiction a ‘Pediatric Disease’ : Health: Speech sends strong signal to Republican-led Congress that the agency will not back off from efforts to regulate tobacco.

In a thinly disguised challenge to the anti-regulatory, Republican-led Congress, the commissioner of the Food and Drug Administration on Wednesday called nicotine addiction “a pediatric disease” that poses a major threat to children and said it should be eradicated much as other significant scourges of childhood have been.

“If we could affect the smoking habits of just one generation, we . . . could see nicotine addiction go the way of smallpox and polio,” said Dr. David A. Kessler in a speech at the Columbia University School of Law in New York.

The address clearly was intended to send a strong signal that--regardless of the mood of Congress--the FDA will not budge from what officials there regard as the single most important item on the agency’s agenda: regulating tobacco.

Despite the growing momentum on Capitol Hill to put at least a temporary halt to all regulation--and despite specific attacks on the FDA by GOP leaders--the agency has continued its tobacco investigation and is counting on continued White House support to keep its efforts from being thwarted by a hostile Congress.

Since the election--and until Wednesday--Kessler had been maintaining a low public profile on the subject of tobacco.

The FDA, which has regulatory authority over drugs, has been working for more than a year to build a case that cigarettes are, essentially, drug delivery systems, with nicotine as the drug. Agency officials say they believe that they have the authority to regulate cigarettes if they can prove that nicotine is a drug and that manufacturers have the ability to control the level of nicotine in cigarettes.

Last August, a key federal advisory committee concluded that nicotine is addictive and that the amounts found in cigarettes now on the market could addict the average smoker.

The FDA has already rejected the idea of banning cigarettes but is exploring the possibility of requiring cigarette manufacturers to gradually reduce nicotine levels to non-addicting amounts over a period of years. Addiction experts say they believe that this could help current smokers wean themselves from the habit and, more importantly, prevent teen-agers who experiment with cigarettes from becoming hooked.

“A person who hasn’t started smoking by age 19 is unlikely to ever become a smoker,” Kessler said. “Young people are the tobacco industry’s primary source of new customers . . . replacing adults who have either quit or died.”

Walker Merryman, a vice president of the Tobacco Institute, dismissed Kessler’s speech as “nothing more than a harsh restatement of his well-known anti-tobacco viewpoint. There isn’t anything new here.”

An aide to Rep. Thomas J. Bliley Jr. (R-Va.), chairman of the House Energy and Commerce Committee, said Bliley--long regarded as a friend of the tobacco industry--would have no comment on Kessler’s remarks.

Immediately after the congressional elections, however, Bliley said on several occasions that lawmakers’ efforts to investigate the tobacco industry, which were spearheaded by Rep. Henry A. Waxman (D-Los Angeles)--then chairman of the committee’s health and environment subcommittee--would end.

Scott Ballin, chairman of the Coalition on Smoking OR Health, which includes the American Cancer Society, the American Heart Assn. and the American Lung Assn., said: “We’re encouraged that Dr. Kessler is speaking out on tobacco and its addictive and deadly effect on kids. And we’re glad to see he hasn’t been dissuaded by threats against the FDA or moves to curb regulation.”

At least 45 million Americans currently smoke, according to federal health officials. It is estimated that about one-third of smokers try to quit every year, but only about 7% succeed.

While smoking among adults has steadily declined since 1964--following a landmark surgeon general’s report--smoking among young people stalled for more than a decade and then recently began to rise, Kessler said.

Between 1992 and 1993, smoking among high school seniors increased from 17.2% to 19%, and among college freshmen, it rose from 9% to 12.5% between 1985 and 1994, he said.

“It is easy to think of smoking as an adult problem,” Kessler said. “It is adults who die from tobacco-related diseases. We see adults light up in a restaurant or bar. We see a colleague step outside for a cigarette break. But this is a dangerously shortsighted view.

“Nicotine addiction begins when most tobacco users are teen-agers, so let’s call this what it really is: a pediatric disease,” he added.

Kessler attacked the industry for targeting children and teen-agers with its advertising and promotion and said most young people try cigarettes out of “childish curiosity,” a “youthful need to rebel” and “wholly without regard for danger.” Then, he said, they find they cannot quit.

“It’s a ritual that often, tragically, lasts a lifetime,” he said. “And it is a ritual that can cut short that lifetime. . . . We owe it to our children to help them enter adulthood free from addiction.”

The Tobacco Institute’s Merryman insisted that the industry bears no responsibility for childhood tobacco experimentation.

“There’s no way in the world he can logically lay that on the doorstep of the tobacco industry,” he said. “We don’t have anything to do with creating or maintaining ‘childish curiosity’ or ‘a youthful need to rebel.’ ”

Furthermore, Merryman maintained that eliminating cigarette advertising or easy availability would do little to discourage smoking among young people.

Teen-agers continue to use illicit drugs and “I can’t remember the last time I saw a billboard for a joint, or LSD available in vending machines,” he said.