Dr. C. Everett Koop, widely regarded as the most influential surgeon general in U.S. history and who played a crucial role in changing attitudes about smoking, died Monday at his home in Hanover, N.H. He was 96.
In 1981, Dr. Koop was 66 and had never served in public office when President Ronald Reagan appointed him surgeon general. By the time he stepped down in 1989, he had become a household name, a rare distinction for a public health administrator.
Dr. Koop issued emphatic warnings about the dangers of smoking, and he pushed the government into taking a more aggressive stand against AIDS. And despite his steadfast moral opposition to abortion, he refused to use his office as a pulpit from which to preach against it.
These stands led many liberals who had bitterly opposed his nomination to praise him, and many conservatives who had supported his appointment to vilify him. Conservative politicians representing tobacco-growing states were among his harshest critics, and many Americans, for moral or religious reasons, were upset by his public programs to fight AIDS and felt betrayed by his relative silence on abortion.
As much as anyone, it was Dr. Koop who took the lead in trying to wean Americans off smoking, and he did so in imposing fashion. At a sturdy 6-foot-1, with his bushy gray biblical beard, Dr. Koop would appear in the gold-braided dark-blue uniform of a vice admiral — the surgeon general's official uniform, which he revived — and sternly warn of the terrible consequences of smoking.
"Smoking kills 300,000 Americans a year," he said in one talk. "Smokers are 10 times more likely to develop lung cancer than nonsmokers, two times more likely to develop heart disease. Smoking a pack a day takes six years off a person's life."
When Dr. Koop took office, 33 percent of Americans smoked; when he left, the percentage had dropped to 26.
Dr. Koop also played a major role in educating Americans about AIDS. Though he believed that the nation had been slow in facing the crisis, he extolled its efforts once it did, particularly in identifying HIV, the virus that causes the disease, and developing a blood test to detect it.