Scott Gottlieb was confirmed Tuesday by the Senate as Commissioner of the U.S. Food and Drug Administration with a vote of 57-42.

He assumes command of an FDA charged with overseeing the $2.4 trillion pharmaceutical, food, medical device, veterinary products and tobacco industries.

Gottlieb last served at FDA during the George W. Bush administration when he was FDA deputy commissioner. He is a cancer survivor who pledged at his confirmation hearing to follow the best science in running the agency.

Minority Democratic senators who opposed his confirmation mostly did so by expressing doubts about Gottlieb’s past financial investments in drugs and medical devices.  The new FDA commissioner had to divest those investments in order to take over the agency under all the usual ethics rules.

FDA regulates one-forth of consumer spending in the U.S., including food, drugs and medical devices along with everything from nutrition labeling, tobacco and e-cigarettes, animal drugs and cosmetics.

In ethics documents, Gottlieb recused himself for a year from decisions involving about 20 companies, including drug giant GlaxoSmithKline, and promised he would resign positions including as a board member or consultant with nine other health-related companies.

Gottlieb also is a resident fellow at the conservative American Enterprise Institute, from which he said he also would resign.