February 5, 2014

Stanton A. Glantz, PhD

CVS pharamacies end the sale of cigarettes (including e-cigarettes until FDA regulation): This is important

In a move that shows real corporate social responsibility CVS/Caremark pharmacies has announced that is it going to stop selling cigarettes.  This is an important substantive move that further removes exposure to tobacco and tobacco marketing from more people's lives and will make an important contribution to reaching former Surgeon General C. Everett Koop's vision of a smokefree society.
 
In press accounts CVS had said that they doubt that this move will actually reduce smoking.  I think that is too pessimistic an assessment.  Millions of people visit their pharmacies and removing tobacco imagery will almost certainly help prevent relapse of people who are trying to quit smoking.  It is also one less place (actually over 7000 less places)  that former smokers will be tempted to impulse by a pack of cigarettes.
 
The obvious next question is what Walgreens will do.  When San Francisco became the first city to prohibit the sale of cigarettes in pharmacies, Walgreens sued to try and block the law (they lost) and Walgreens still sells cigarettes in it Fisherman's Wharf (a tourist area in San Francisco; photo courtesy of Matt Springer) store because that store does not include a pharmacy.  Walgreens (and every other pharmacy) needs to follow CVS's lead.
 
This is an important symbolic step because it further send the message that tobacco is no longer part of civilized society and reinforces the fact that the cigarette/tobacco (which are increasingly the e-cigarette companies) are not legitimate businesses. As the federal RICO lawsuit against the cigarette companies (described in our book Bad Acts) established, the companies are racketeers, who are still under court orders designed to inhibit their ongoing "enterprise" to defraud the public.  No legitimate business should be selling their products, something Walmart, the world's largest purveyor of cigarettes should consider.
 
And this symbolism could have important impacts on smoking.  We have shown both in California  and nationally that young adults who don't like or don't trust the tobacco companies are much less likely to smoke and, if they smoke, much more likely to be planning to quit.
 
It is also significant that CVS does not sell e-cigarettes and will not sell them until the FDA provides some "guidance."  This is another responsible act, since not a single e-cigarette company has submitted an application to market c-cigarettes as either smoking cessation aids or reduced risk products, despite aggressively promoting these claims
 
On this count, CVS is acting much more forcefully and responsibly than the Obama Administration's FDA, which is still sitting quietly while the e-cigarette companies make these unsupported therapeutic claims that e-cigarettes are effective for smoking cessation.  The FDA has the current authority right now under current law and court decisions to initiate an enforcement action to stop these unsubstantiated claims.

Comments

Comment: 

I would suggest rewarding CVS and putting pressure on other pharmacies by each of us moving our individual prescriptions from our current pharmacies to CVS.  If we did this as a nationwide movement, it could have a really positive impact on CVS AND put pressure on competing pharmacies to do the same.
 

Comment: 

CVS said this won't reduce smoking? The tobacco industry didn't fight tobacco free pharmacies because it knew they'd have no effect on smoking.
Now: in the short term, this won't have a large effect. Smokers will buy elsewhere. But pharmacy sales of this product are intensely normalizing. How bad could it be, when it's sold at every CVS, right next to those health products, that health slogan, this health campaign:
  http://www.rawbw.com/~jpk/stand/Pictures.html.
Over the long term, losing the normalizing will reduce smoking. The industry knows it. That's why it fights it.
CVS now joins Target, Medicine Shoppe, Wegmans, and many other retailers in getting out of the tobacco dealer business. Millions of Americans are now seeing this product as not normal. This is a powerful change and it will be effective.
I'm not aware of a thing FDA has done that is effective in preventing tobacco disease, disability, and death.
-- Jon Krueger

Comment: 

Two words: Where's Walmart?   For at least five years, the world's largest retailer and third largest U.S. pharmacy chain has said it is "considering" ending tobacco sales. Compare rival Target, which bravely pulled tobacco products eighteen years ago because of difficulties preventing sales to minors.
Doug Blanke
Public Health Law Center
http://www.publichealthlawcenter.org" title="www.publichealthlawcenter.org";www.publichealthlawcenter.org
 
 
 
 
 
 
 
 
 
 
 

Comment: 

Thanks Stan. This is huge and may have wider ramifications. As a for profit company  they must be applauded for their honest intentions and a great pro-public health decision. Best. Surendra
 
Surendra Bir Adhikari, PhD MedSoc
Research Administrator & Health Disparities Lead
Office of Quality, Planning, and Research
Ohio Department of Mental Health & Addiction Services

Comment: 

But patience and persistence will win the race. Remember with the airline smoking ban we were told we would get no votes, so we snuck a two hour ban paragraph into the Transportation bill, then the public demanded more so we got a six hour ban and so on and so forth. You are a true hero of mine Stanton, thank you for all you have done and continue to do. I am switching to CVS from Walgreens immediately. Suzette Ahrendt-Janoff

Comment: 

Nice job CVS! I hope that other pharmacies follow suit. Way to take the lead on promoting health and wellness.

Comment: 

A foreign example may not be of that much direct help but, several years ago, here in Quebec, 'l'Ordre des pharmaciens' tried to get cigarettes out of drugstores on the grounds, similar to statements made today, that the 'sale of tobacco products was incompatible with the exercise of their profession'. Opposition was led by the white-smoked Jean Coutu, pharmacist owner of an eponymous chain, largest in the province. When the law finally changed and the battle was won, Coutu trumpeted loudly it was the best move he ever made, freeing space for more profitable and alluring displays near the cash.
 JAMA has published a Viewpoint, co-authored by Troyen Brennan, Executive Vice President and Chief Medical Officer of CVS Caremark, that makes the case for this overdue, if welcome move. Open Access, highlights here:
“Making cigarettes available in pharmacies in essence “renormalizes” the product by sending the subtle message that it cannot be all that unhealthy if it is available for purchase where medicines are sold. The argument that pharmacies also sell tobacco-cessation products only heightens the paradox. This is primarily a US problem: pharmacies in other developed countries do not sell cigarettes... Although the sale of tobacco products in CVS pharmacies produces more than $1.5 billion in revenues annually, the financial gain is outweighed by the paradox inherent in promoting health while contributing to tobacco-related deaths. As a result, CVS has decided to cease tobacco sales in a phased approach over the next year.
“This action may not lead many people to stop smoking; smokers will probably simply go elsewhere to buy cigarettes. But if other retailers follow this lead, tobacco products will become much more difficult to obtain. Moreover, if people understand that retail outlets that plan to promote health, provide pharmacy services, and house retail clinics are no longer going to sell tobacco products, the social unacceptability of tobacco use will be substantially reinforced—indeed, the continued sale would appear to sanction the most unhealthy habit a person can maintain. If pharmacies do not make this effort voluntarily, federal or state regulatory action would be appropriate.” [Brennan TA, Schroeder SA. Ending Sales of Tobacco Products in Pharmacies, JAMA]
<a forcediv="true" forceinline="true" href="http://jama.jamanetwork.com/article.aspx?articleid=1828530" target="http://jama.jamanetwork.com/article.aspx?articleid=1828530&h=1aqfsm9cc&e... rel="nofollow" saprocessedanchor="true" target="_blank";http://jama.jamanetwork.com/article.aspx?articleid=1828530

Comment: 

Snapped in a Marin Costco last weekend. Not pictured: a full NJoy display behind the Blu, facing the pharmacy. Note the Nicorette display just across the aisle.
David Cash
UCSF TCORS Project 2
&nbsp;
<img alt="" src="http://home.comcast.net/~dccash/pwpimages/Costco_ecig.JPG" /;

Comment: 

&nbsp;
To build on this success, I suggest a key message to send
the other big chains (Walgreens, Rite Aid, Wal-Mart):
the question is no longer who will be first;
the question is now who will be last.
&nbsp;
Who will be the last pharmacy to sell cigarettes?
&nbsp;
Who will be the last pharmacy to give it up?
&nbsp;
Target is tobacco-free. Wegmans. Medicine Shoppe. Now CVS.
&nbsp;
What will it look like for yours to be the pharmacy
that kept on selling highly addictive product that
kills half its customers? Will that square with the
health image you want to project?
&nbsp;
Time is ticking. Who will be last?
&nbsp;
-- Jon

Comment: 

I think it would be a great idea to support CVS by switching our prescription medications to CVS. &nbsp;
I would suggest calling your current pharmacy and explain why you are changing and this switch your medications to CVS. &nbsp;This will provide positive feedback to CVS and encourage other pharmacies to follow suit.
I would like to see this become a "National Movement"
Robert Shepard, MD
Helena, MT

Comment: 

CVS gets it right, and so does Stan Glantz. &nbsp;While the tobacco companies like to claim that they have become "socially responsible," despite the label they deserved and earned in the federal tobacco litigation as "racketeers," CVS actually does something real and meaningful for health--now that's social responsibility, coming from a corporation, no less. &nbsp;And it really wasn't even that hard. &nbsp;FDA, take note and move forward--you have had the authority for almost 5 years, so do something about menthol, do something about e cigs, DO SOMETHING!
Sharon Eubanks &nbsp; &nbsp;

Comment: 

I posted thanks to CVS's headquarters off of Cynthia's ANR list post, but I also went to the local Long's where I've shopped for 15+ years and have regularly groused to the manager about aggressive&nbsp;child-eye height&nbsp;cigarette advertising behind the cash registers, etc. &nbsp;I bought a half-dozen bags of Valentine's Day candy and asked he share those in the staff room as my congratulations and thanks. &nbsp;The staff is going to be the front lines for the change over (to the extent there will be unhappy customers) and they'll hardly reap much in benefits. &nbsp;
Though it hardly rises majorly, feel free to follow or share the idea for anyone else crazy enough to do this, &nbsp; It would be really powerful for CVS's management team to be hearing from its local stores if this kind of real grassroots messaging took hold virally. &nbsp;And besides, the staff deserves thanks here too.
&nbsp;
Aloha,
&nbsp;
Mark L.

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