Help stamp out pharmacy tobacco sales

It has been 10 years since Drug Topics  published our Viewpoint article, "Make New Year's Resolution: Stub Out Tobacco," [Anh Lê, Frederick S. Mayer, and Sarah Elisabeth Curi, Vol. 148, No. 1, January 12, 20040], in which we called on pharmacies and pharmacists nationwide to stop selling cigarettes.  In the same issue, Fred Gebhart's article, "Some chains still resist pulling tobacco products," referred to a presentation made by Fred Mayer at the American Public Health Association Meeting in San Francisco in November 2003:

"If pharmacist and public health advocate Frederick Mayer, RPh, MPH, had his way, pharmacies nationwide would not sell tobacco products. ‘You can't advertise yourself as the best pharmacy in town while you sell cigarettes that kill people. If pharmacies are serious about promoting health, we have to form coalitions to get tobacco out of pharmacies just like we have gotten handguns and ammunitions out of chain stores. We are in business to make people healthy, not sell them products whose purpose is to kill.’”

As a registered pharmacist and public health advocate and activist, Fred Mayer has worked on the issue of stamping out tobacco sales at pharmacies for over 50 years, and proudly got rid of tobacco sales at the pharmacy he owned and operated in Sausalito, California.

We applaud CVS Caremark Pharmacy's announcement on February 5th that it will stop selling cigarettes at its 7,600 stores by October 1. 

CVS CEO and President Larry Merlo's statement, "It is the right thing for us to do for our customers and our company to help people on their path to better health.  Put simply, the sale of tobacco products is inconsistent with our purpose," not only shows CVS' commitment to protecting the health of Americans and their families, but also to putting ethics over profits derived from selling a product that debilitates and kills its victims.

According to the U.S. Centers for Disease Control and Prevention, and the 2014 U.S. Surgeon General's Report on Smoking and Health:

- Smoking causes cancer, heart disease, stroke, lung diseases (including emphysema, bronchitis, and chronic airway obstruction), and diabetes.

- Cigarette smoking is responsible for more than 480,000 deaths yearly in the U.S., including an estimated 42,000 deaths resulting from secondhand smoke exposure. 

- For every person who dies from a smoking-related disease, about 30 more people suffer with at least one serious illness from smoking.

- On average, smokers die 10 years earlier than nonsmokers.

- If smoking persists at the current rate among youth in this country, 5.6 million of today¹s Americans younger than 18 years of age are projected to die prematurely from a smoking-related illness. This represents about one in every 13 Americans aged 17 years or younger who are alive today.

- The cost of more than $289 billion yearly, including at least $133 billion in direct medical care for adults and more than $156 billion in lost productivity, results from smoking.

Tobacco kills more Americans yearly than alcohol, illegal drug use, homicides, automobile accidents, suicide, and AIDS combined.

Pharmacists are health care providers involved in treating or preventing illness, and promoting health. Something is seriously wrong when pharmacies are pushing tobacco products to make their customers sick and kill them, while selling smoking cessation products, and medications to treat diseases caused by smoking.

Troy Brennan, M.D., Medical Officer at CVS Caremark, and Steven A. Schroeder, M.D., Director,  Smoking Cessation Leadership Center, University of California, San Francisco, wrote in the Journal of the American Medical Association (JAMA, online, February 5, 2014): 

"The paradox of cigarette sales in pharmacies has become even more relevant recently, in large part because of changes in the pharmacy industry.  Most pharmacy chains are retooling themselves as an integral part of the health care system. They are offering more counseling by pharmacists, an array of wellness products and outreach to clinicians and health care centers.  Perhaps more important, pharmacies are moving into the treatment arena, with the advent of retail health clinics. These retail clinics, originally designed to address common acute infections, are gearing up to work with primary care clinicians to assist in treating hypertension, hyperlipidemia and diabetes all conditions exacerbated by smoking."

The American Pharmacists Association (APhA) has been a leader on the issue of banning tobacco sales at pharmacies, and has adopted policies advocating such a ban. Along with APhA, the American Public Health Association, American Medical Association, American Cancer Society, American Lung Association, American Heart Association, and other health groups have called for this ban. 

The American Public Health Association (APHA) now has a petition asking all retailers that operate pharmacies or clinics to stop selling tobacco products. We urge you to sign this petition. Ask your family members, friends, and others in your community to join you in signing this petition. Spread the word where you live, and in your professional networks.

Kudos to CVS for its bold stance against the Merchants of Death, the tobacco industry.

But our campaign to ban tobacco sales at pharmacies is not over yet.

Let us call on Walgreens, Rite Aid, and other chain pharmacies and retail outlets to follow CVS' footsteps.

We must also advocate strongly for legislation at the local, state and national levels to ban tobacco sales at pharmacies.

Let us also urge chain pharmacies and retailers to not sell "electronic cigarettes," and advocate for legislation to ban their sales at such outlets. 

The FDA has determined that "e-cigarettes," many of which are produced by tobacco companies, contain nicotine, carcinogens, and a variety of dangerous chemicals.

 In 2004, we wrote, "Through concerted action, pharmacists can achieve the important public health goal of eliminating tobacco sales from pharmacies and at the same time uphold their ethical code of protecting patients health and welfare." 

Now more than ever, as pharmacists you have a significant and historic role in making this goal a reality nationwide, to protect the health of those you serve and their families.

Anh Lê is a public health advocate in the San Francisco Bay area. E-mail him at anhle213@sbcglobal.net. Fred Mayer, RPh, MPH,  is president of Pharmacists Planning Services, Inc., a nonprofit, consumer, public health, pharmacy, and education organization. He lives in San Rafael, Calif. E-mail him at ppsi@aol.com or visit ppsinc.org.