HEALTH : Clinton Science Appointees Are Beginning to Speak Out

WASHINGTON — President Clinton’s decision to treat nicotine in tobacco as a drug that can be regulated by the federal government reflects not only his own inclinations, but also a new sense of activism on the part of his appointees to top biomedical research jobs.

“I think we have to take a higher profile and speak out, especially when the science is so absolutely unmistakable,” Dr. Richard D. Klausner, the new director of the National Cancer Institute, said in a wide-ranging interview.

“The time really has come to move what we know about tobacco and cancer out of the arcane halls of research and into society with effective intervention,” he said. “The scientific evidence demands action.”

Klausner’s style is a notable departure from that of most government scientists, who tend to stay in their labs and keep their heads down when scientific issues generate political controversy.

Dr. Bernadine P. Healy, for example, who headed the National Institutes of Health under former President George Bush, remained quiet about Bush’s ban on federally funded fetal tissue research because of its relationship to the volatile abortion issue. She did so despite her previous public support of the work.

All too often, congressional funding of critical biomedical programs depends on not offending lawmakers, and on walking a neutral line in promoting and defending federal research needs. Moreover, Clinton’s intention to regulate cigarettes already has ignited a firestorm on Capitol Hill.

But Klausner and his boss, Dr. Harold E. Varmus, the current NIH director, said they felt strongly that as scientists overseeing the country’s health research enterprise, they could not remain silent on the ill effects of tobacco.

Together, they wrote a letter to Clinton and later met with him privately at the White House to urge that he approve the Food and Drug Administration’s controversial proposals aimed at curbing teen-age smoking.

“I think the President felt as passionately as we did,” said Klausner, the father of two boys, ages 5 and 12. “It was clearly an example of doing what was right. I was very proud to be part of that process.”

Klausner, 44, a molecular biologist, recently replaced outgoing institute head Dr. Samuel Broder, who left to join a Miami pharmaceutical company.

On other subjects, Klausner said that the cancer research community in recent years has undergone a revolution in its understanding of cancer, and the way in which normal cells become cancerous.

The challenge now is to close the gap between this advancing knowledge, and the less encouraging progress in treating patients, he said. Cancer kills one in five Americans, and by the year 2000 is expected to surpass heart disease as the leading cause of death in this country.

Cancer “is a genetic disease, which is different from an inherited disease,” he said. “Changes in genes are involved. Cancer is a disease of the instability of the human genome.”

Recent findings have shown that all of the body’s cells constantly scan themselves for genetic mistakes and damage caused by environmental factors, such as smoking, he said. They are programmed to kill themselves when they find something wrong.

“The cell either fixes itself, or commits suicide,” he said. “When the cells don’t commit suicide, cancer is what happens.”

Such information came from finally learning exactly how chemotherapy worked when it was successful, he said.

“We never knew why chemotherapy worked, when it worked, so we couldn’t know why it failed,” he said. “Then suddenly we began to understand. . . . It worked not because we gave poisonous agents that killed the cancer cells, but because it triggered the cancer cells to commit suicide.”

This information could be used to develop new therapy, or to delay the onset of cancer for decades. Cancer risk “increases by age because you are accumulating all these mistakes.”