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Everett Koop — from pariah to paragon

Leading tobacco-control advocate Mike Daube pays his respects to an elder statesman of American public health

If former United States Surgeon General Everett Koop, who died on 25 February at the age of 96, had died in 1981, obituaries would have described him as a distinguished and innovative paediatric surgeon and teacher, widely known for his evangelical Christianity and his leadership in the antiabortion movement that endeared him to many conservatives in the US.

When Republican president Ronald Reagan — who earlier had featured as an actor in cigarette advertisements — nominated him as Surgeon General in 1981, the opposition from Democrats, media and many in the public health community was instant and ferocious. A New York Times editorial headed “Dr Unqualified” claimed that he lacked public health credentials, was too old and conservative, and his appointment would “be an affront both to the public health profession and the public”.1

By the end of his term in 1989, Koop was a public health hero. Surgeons General have little power: they depend for their impact on the role’s prestige, selection of issues, political savvy and…