“If we had responded to the crack cocaine epidemic as we should have, we wouldn’t have had the opioid epidemic,” Dr. Satcher said.

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In 1992, Dr. Novello said, the first Bush White House ordered her to stop condemning Joe Camel cartoons for marketing cigarettes to children. Five years later, under increasing pressure, R.J. Reynolds Tobacco retired the character.

In 1994, from behind a desk bouquet of faux roses made of condom wrappers, Dr. Elders, the first black Surgeon General, called teen pregnancy “a form of slavery” for young black women and vigorously backed sex education, birth control, and wider use of the RU-486 abortion pill.

She also suggested legalizing drugs as a way to cut crime and jail crowding.

In response, she was pilloried.

Conservatives accused her of promoting premarital sex and drug addiction, black leftists accused her of promoting black genocide. Mr. Clinton first rebuked her and then later dismissed her over an offhand answer she gave at an AIDS conference. Asked if she thought teaching children about masturbation could reduce unsafe sex, she answered that it was part of human sexuality and “perhaps should be taught.” (She later explained that she meant children should be told it was normal, not be given how-to instructions.)

“I have no regrets,” Dr. Elders said at the academy. “If I had to do it all over again, I’d do it the same way. I thought I did it right the first time.”

After she was forced out, Mr. Clinton admitted to an extramarital affair. Since those days, thanks largely to measures she backed, birthrates have plummeted among both black and white teenage girls. Marijuana is now legal in many states. And masturbation is more often an issue for adult men caught by the #MeToo movement.