Pharmacy cigarette sales must end - - Drug Topics


Pharmacy cigarette sales must end

Drug Topics

Key iconKey Points

  • San Francisco banned pharmacy cigarette sales in October 2008.
  • Boston's health commission approved a ban in December 2008.

Daniel A. Hussar, PhD
The sale of cigarettes in pharmacies is the topic of a letter from a physician in the Nov. 1 issue of Family Practice News. His letter includes the following observations: "That ... chain drugstores continue to profit from the sale of cigarettes makes a mockery of the pharmacist as an ally in health promotion ... I recently received a packet from CVS/Caremark purporting to educate me about 'safe and effective drug therapy' in the management of coronary heart disease ... I filed this packet next to my recent photographs of the electronic billboard at one local CVS that alternately flashes 'We accept ALL Medicare Rx Plans' and 'Marlboro Carton $30.49.'"

Some others have such strong concerns about the sale of cigarettes in pharmacies that they have taken action. Last October, the city of San Francisco banned the sale of cigarettes in pharmacies, although pharmacies located inside "big box" or grocery stores are exempt (an unfortunate concession, but one that does not diminish the importance of the action taken). The mayor of San Francisco is on record as saying, "Pharmacies should be places where people go to get better, not where people go to get cancer." It is noteworthy that the mayor and board of supervisors of San Francisco have a more positive image of pharmacies than the cigarette-selling pharmacies apparently have of themselves.

When we reach the time when we can look back and remember when pharmacies used to sell cigarettes, we will identify the action of the city of San Francisco as the "tipping point" that provided the determination and momentum to get cigarettes out of all pharmacies.

In December, the Boston Public Health Commission approved a ban on the sale of tobacco products at health and educational institutions, including pharmacies and drug stores and college and university campuses. This ban does not include exceptions based on the type of store (e.g., grocery stores) in which the pharmacy is located.

The comments and actions of some chain pharmacies regarding the sale of cigarettes are an embarrassment to the profession of pharmacy. Walgreens, after failing in its effort to obtain a preliminary injunction against the San Francisco ban, has filed a lawsuit challenging the city's action. Walgreens contends that it is discriminatory for the city to ban the sale of cigarettes in pharmacies but not in the big-box and grocery stores that contain pharmacies (an allegation that should be addressed by eliminating the exceptions). The city of San Francisco responds to Walgreens' allegation by observing that a much higher percentage of Walgreens' revenues come from prescription medications compared with those of big-box and grocery stores, and that pharmacies like Walgreens are viewed by consumers as health-promoting businesses. The attorney representing Walgreens responded with what I consider to be a shocking statement: "There is no evidence in the record that suggests that a Walgreens pharmacy is more health-promoting than a pharmacy at any other establishment." I will accept his statement as accurate, but attempting to make a case by disclaiming a healthful image is disgraceful.

In a discussion with a CVS official, I was informed that, although CVS sells cigarettes, it does not promote them. The physician letter I reference here contradicts this statement, as does a photograph I have of a CVS pharmacy with a large sign in its window promoting low cigarette prices.

With the exception of a small number of pharmacists, pharmacy has essentially been silent about the serious blemish on our healthcare image resulting from the sale of cigarettes in pharmacies. Individual pharmacists and our pharmacy associations must take action to stop this practice, and there are numerous strategies that can be employed. Executives of chain pharmacies that sell cigarettes should be challenged. The thousands of independent pharmacies, as well as chains such as Target and Wegmans, that do not sell cigarettes should be commended. I am convinced that the time when we look back and remember how pharmacies used to sell cigarettes can occur soon. Let's make Jan. 1, 2010, our goal for discontinuing the sale of cigarettes in all pharmacies and stores/facilities that contain pharmacies.

Daniel A. Hussar, PhD, is Remington Professor of Pharmacy at the Philadelphia College of Pharmacy.

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Drug Topics is a monthly news magazine, guided by a board of pharmacy leaders, reporting on all phases of community, retail, and health-system issues and trends. We cover managed care and professional, national, and state activities as well as new therapies involving prescription and OTC drugs.



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