Drug Stores and the Sale of Tobacco Products

Isn't it ironic that in the U.S. many drug stores or pharmacies are the source not only of medications that save lives and cure diseases but also of tobacco products that shorten lives and cause disease? The Centers for Disease Control and Prevention tells us that tobacco is the leading preventable cause of death in the United States, yet many drug stores and pharmacies feature these products for sale in the front of the store.

Most chain pharmacies sell tobacco products, but the majority of independent pharmacies do not sell them. The concern for the negative image projected by a pharmacy selling tobacco products dates back nearly 20 years. An article in the April 25, 1994 edition of "The New York Times," reported that hundreds of independent pharmacies across the United States had taken tobacco products off their shelves. Pressured by county medical societies and pharmaceutical associations, independent pharmacies in Michigan, Rhode Island, Minnesota, Utah and the state of Washington stopped selling tobacco products in late 1993. Even in the tobacco-growing state of South Carolina some pharmacies removed tobacco products. Pressure from the medical community was not the only factor contributing to the removal of tobacco from pharmacy shelves. Many of the owners of these independent pharmacies were troubled by the fact that long-time customers who bought tobacco products were dying of lung cancer. Even in stores of the chain pharmacies, some pharmacists viewed it as unethical to ring up sales of cigarettes at the prescription drug counter. Instead, they directed the customer to the general merchandise check out counter.

Efforts to get tobacco products off pharmacy shelves were given a big boost in March 1994 when Dr. David Kessler, who at that time was the commissioner of the Food and Drug Administration, testified before the U.S. Congress that some cigarette makers had manipulated the nicotine content of their products. The effect of this manipulation was to make the cigarettes more addictive.

Fast forward now to October 1, 2008. On that day, a San Francisco city ordinance banning the sale of tobacco products in all pharmacies went into effect. Thus, San Francisco became the first American city to ban tobacco sales in pharmacies. Prior to the passage of this ordinance, the citizens of San Francisco were engaged in a vigorous debate about the impact of banning tobacco sales in pharmacies. During this public debate, four professors from the University of California at San Francisco School of Pharmacy published a position paper in which they declared their full support for the ban on the sale of tobacco products in pharmacies. In additon, the paper included results of their poll of California consumers regarding the ban of tobacco sales. In this poll, 72% of Californians said they did not favor the sale of tobacco products in pharmacies, and 83% said that if their pharmacy stopped selling cigarettes, they would continue to shop there just as often as they always had. Some of the respondents (14%) said they would shop at the pharmacy more often after tobacco products were gone.

Soon after San Francisco's bold action, in February 2009, the city of Boston became the second U.S. city to ban the sale of tobacco products from all pharmacies when new rules approved by Boston's commissioner of public health took effect. Now, the state of Massachusetts is considering a ban on tobacco sales in all pharmacies throughout the state.

According to Michael Cohen, president of the Institute for Safe Medication Practices, the medical community has solidified its efforts to make the sale of tobacco products in pharmacies in the U.S. a thing of the past. In an article in the February 6, 2012 issue of "The Philadelphia Inquirer," he says that the American Medical Association, the American Pharmacists Association and the American Society of Health-System Pharmacists have issued a public appeal for the cessation of sales of tobacco products in pharmacies. In addition, many pharmacists are working actively within organizations which have made it their mission to stop tobacco from being sold in pharmacies. One of these organizations is presently engaged in picketing some drug stores in Washington, D.C.