Cigarettes, cigars, and the like are the most deadly product that consumers can legally buy. Why they are sold in pharmacies, which are meant to dispense medications and other things designed to heal or promote health, has always been a mystery to me. I’m not alone. The American Pharmacists Association, the American Medical Association, and other groups have urged pharmacies to stop selling cigarettes.
Several major pharmacy chains have been mulling over whether they should take this advice. Today, one of them has acted. The CVS chain has decided to stop selling tobacco products, and will phase out their sales over the next year. The news came in a press release from CVS and an opinion piece published today in JAMA, the journal of the American Medical Association.
The authors of the article are Dr. Troyen Brennan, executive vice president and chief medical officer of CVS Caremark, and Dr. Steven A. Schroeder, director of the Smoking Cessation Leadership Center at the University of California San Francisco. (Full disclosure: both have been close colleagues of mine for many years.)
A shrinking circle
Fifty years ago, when the Surgeon General issued his famous document summarizing the health risks of smoking, more than 40% of American adults smoked. It was okay to smoke anywhere and everywhere—in restaurants, grocery stores, airplanes, and even in hospitals. It wasn’t until the mid-1980s that Brigham and Women’s Hospital, where I work, became one of the first hospitals to ban smoking inside its buildings.
Efforts to limit where people can smoke and buy cigarettes and other tobacco products has helped reduce the number of smokers to about 18% of adults in the United States. Increasing the cost through taxes has also put a dent in the number of smokers.
But we need to do more. There’s abundant evidence that making tobacco products hard to get reduces their rate of use. So I applaud CVS’s decision to stop selling tobacco products in its stores. With this public announcement from its chief medical officer, CVS is claiming the high ground. The company estimates that it takes in $1.5 billion a year from selling tobacco products, but “the financial gain is outweighed by the paradox in promoting health while contributing to tobacco-related deaths.”
Pharmacists will likely cheer the decision. According to Brennan and Schroeder, one survey of pharmacists showed that only 2% of them favor the sale of tobacco products in their stores.
It also makes sense as large chains begin to make themselves over as health care outlets, with in-store retail clinics. It has always been sadly ironic to see someone come to a drug store to get his or her medicines for high blood pressure, high cholesterol, diabetes, or pain from metastatic cancer—and then stop at checkout and get a pack of the substance that caused and continues to perpetuate those illnesses.
I hope other pharmacies follow CVS’s lead. It would be a good step toward “making smoking history.”