Health oriented organizations and President Barack Obama praised the move.
“As one of the largest retailers and pharmacies in America, CVS Caremark sets a powerful example, and today’s decision will help advance my administration’s efforts to reduce tobacco related deaths, cancer, and heart disease, as well as bring down health care costs ultimately saving lives and protecting untold numbers of families from pain and heartbreak for years to come,” Obama said in a statement Wednesday.
“This is an important, bold public health decision by a major retail pharmacy to act on the long understood reality that blending providing health care and providing cigarettes just doesn’t match,” said Dr. Richard Wender, chief cancer control officer at the American Cancer Society.
“We need an all hands on deck effort to take tobacco products out of the hands of America’s young generation, and to help those who are addicted to quit,” Health and Human Services Secretary Kathleen Sebelius said in a statement. “Today’s CVS Caremark announcement helps bring our country closer to achieving a tobacco free generation. I hope others will follow their lead.”
It remained unclear whether other pharmacies will follow CVS’ lead.
“We have been evaluating this product category for some time to balance the choices our customers expect from us with their ongoing health needs,” Walgreens spokesman Jim Graham said in a statement.
“We will continue to evaluate the choice of products our customers want, while also helping to educate them and providing smoking cessation products and alternatives that help to reduce the demand for tobacco products.”
Meanwhile, David Howard, spokesman for R.J. Reynolds Tobacco Co., said, “We value the long term relationship with CVS and respect their commercial decision. We will work with them as they transition out of the tobacco category in the coming months.”
Stopping cigarette sales comes at a price. CVS Caremark estimates it will take an annual loss of $2 billion from tobacco shoppers $1.5 billion in tobacco sales and the rest from other products tobacco shoppers purchase while in the store.
The company has enjoyed growing revenues in recent years, boosted by its pharmacy services business and prescription drug sales.
CVS Caremark hasn’t reported its year end results yet, but it took in nearly $94 billion in revenues in the first nine months of 2013, up slightly from the same period in 2012, according to its most recent earnings report.
In 2012, CVS Caremark reported $123.1 billion in revenues, a 15% jump from $107.1 billion the previous year.
“We commend CVS for putting public health ahead of their bottom line and recognizing the need for pharmacies to focus on supporting health and wellness instead of contributing to disease and death caused by tobacco use,” the American Medical Association said.
Asked Wednesday about the reaction of tobacco executives to the decision, CVS Caremark’s Merlo said they were “disappointed. At the same time, I think they understand the paradox that we face as an organization, and they understand the rationale for the decision.”
On whether CVS would extend its ban to other products known to be unhealthy candy, potato chips or alcohol, for instance Merlo told reporters those items, in moderation, do not have the same adverse effects as the use of tobacco.
We know it can kill us Why people still smoke
Helping people quit
The company also announced Wednesday it plans to launch a national smoking cessation program in the spring. The program will include information and treatment on smoking cessation at CVS/pharmacy and Minute Clinic locations in addition to online resources.
Members of the pharmacy benefit management plan will be able to access comprehensive programs to help themselves stop smoking.
Smoking cessation products such as nicotine patches or gum will continue to be available at CVS/pharmacy locations, Dr. Troyen Brennan, chief medical officer for CVS Caremark, said Wednesday.
The last cigarette Nine ex smokers who quit the habit for good
Fewer people smoke today than in the mid 20th century, but there are still a lot of Americans lighting up. In 1965, 42% of the population smoked, compared with 19% today, according to the Centers for Disease Control and Prevention. Experts said the decline in smoking has plateaued.
It’s no secret that tobacco causes health problems. Cancer, stroke, heart disease and lung diseases are among the results of smoking, according to the CDC. More than 5 million deaths per year are caused by tobacco use. Smokers also tend to die 10 years before nonsmokers, according to the CDC.
Support from public health advocates
The company’s announcement is “a huge step toward our country being able to have a really long lasting culture of health,” said Dr. Risa Lavizzo Mourey, president and CEO of the Robert Wood Johnson Foundation, the largest U.S. philanthropy devoted to public health.
In addition to eliminating a point of sale of tobacco, CVS Caremark’s removal of tobacco products also takes away an advertising opportunity, said Robin Koval, president and CEO of Legacy, an organization that conducts research on tobacco use. Young people who shop at CVS/pharmacy for other reasons will no longer see the array of tobacco products available.
“It’s obviously a landmark decision and one that I hope wakes up the entire retail industry that it’s the right thing to do,” Koval said.
FDA launches teen anti smoking campaign
A report from the California Department of Public Health found that while total cigarette sales decreased between 2005 and 2009 in the United States, sales in pharmacies increased. If sales of cigarettes at pharmacies continue rising at the current rate, by 2020 almost 15% of all U.S. cigarette sales will occur at pharmacies, the report said.
According to a 2011 study in Los Angeles, cited in the report, more than 32% of pharmacies sold cigarettes, and traditional chain pharmacies were far more likely to sell cigarettes than independently owned pharmacies.
Wender noted the CVS move is in line with what the American Cancer Society, American Heart Association, American Medical Association, American Lung Association and American Pharmacists Association have advocated to stop sales of tobacco in retail outlets with pharmacies.
On the other side of the issue, there is a lot of money in tobacco. The cigarette industry spent $8.37 billion in 2011 on advertising and promotions, according to the CDC.
Most tobacco is sold in convenience stores, which would be “a tougher nut to crack” in terms of stopping tobacco sales, Wender said.
But pharmacies are a good place to start, Wender said. He is convinced the removal of tobacco products from CVS/pharmacy locations will result in some smokers quitting, particularly those who have a habit of buying their cigarettes there.
“It’s going to force every one of them to pause and say, ‘Why isn’t my CVS selling cigarettes anymore?’ ” Wender said.
How you can prevent most kinds of cancer
CNNMoney’s Melanie Hicken and Aaron Smith and CNN’s Jen Christensen and Miriam Falco contributed to this report.
Jacob sullum on e-cigarettes: sowing confusion among anti-smoking activists
E cigarettes have taken us back 50 years, according to the headline over a commentary that National Jewish Health, a medical centre in Denver, recently paid to place on the op ed page of The New York Times. The essay co authored by David Tinkelman and Amy Lukowski, who are in charge of the hospital s health initiatives, including its tobacco cessation program never substantiates that claim, which is typical of e cigarette critics who see a public health menace where they should see a way of reducing tobacco related disease and death.
Selby, Sweanor & Hughes E cigarettes could save the government billions
Innovation is a powerful thing. It has dramatically increased our quality of life, and the entrepreneurial spirit behind it continues to amaze us. If someone from 1964 were to see the computers, automobiles or medical diagnostics we have today, they would be astounded. But former U.S. surgeon general Luther Terry, who released the first ground breaking Report of the Surgeon General on Smoking and Health 50 years ago, would be saddened that cigarettes have not appreciably changed. They are still the same deadly and defective delivery system for nicotine and they remain, by far, the leading cause of preventable death, despite sound policy and improved treatment.
Although there has been little to no innovation in cigarettes (evidence suggests they may actually be more harmful today than they were in the past), there have been great advances in potentially massively less harmful ways to deliver nicotine to the body, such as electronic cigarettes. Unfortunately, Health Canada s policy to these game changing devices has been confused, to say the least.
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You might think people concerned about the health effects of smoking would welcome an alternative that involves neither tobacco nor combustion and is therefore much less hazardous. But with some notable exceptions, anti smoking activists and public health officials have been mostly hostile to electronic cigarettes, which deliver nicotine in a propylene glycol vapour. This puzzling resistance seems to be driven by emotion rather than science or logic.
Tinkelman and Lukowski concede that e cigarette vapor contains far fewer toxic chemicals and carcinogens than does tobacco smoke and that if e cigarettes are used to wean individuals off tobacco or to significantly reduce the amount smoked per day, this is a good result. But they worry that if e cigarettes used by non smokers produce nicotine addiction and smoking habits that lead to new tobacco use, e cigarettes are causing harm. Judging from their headline, Tinkelman and Lukowski think that harm not only threatens to outweigh the health benefits of replacing smoking with vaping but could even reverse half a century of progress against tobacco related disease, giving us smoking rates similar to those in the early 1960s, when most American men and a third of women smoked compared to about 22% and 17%, respectively, today.
Despite Tinkelman and Lukowski s over the top fears, there is no evidence that e cigarettes are serving as a gateway to the real thing. They cite survey data indicating that e cigarette use among middle and high school students from 2011 to 2012 doubled to 1.8 million users, adding that nearly 160,000 of those adolescents do not use tobacco, highlighting the danger e cigarettes present. Another way of putting it Just 7% of teenagers had ever tried e cigarettes as of 2012, and 91% of them were smokers. Far from alarming, that fact suggests some young smokers may end up switching to vaping, thereby dramatically reducing the health risks they face. That would be a good result, as Tinkelman and Lukowski acknowledge.
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What about the nonsmokers who account for 9% of the teenagers who have tried e cigarettes? There is little reason to think they will become regular vapers, let alone smokers. In a 2013 survey of 1,300 college students, only one respondent reported trying e cigarettes before smoking the conventional kind. It didn t seem as though it really proved to be a gateway to anything, said the lead researcher. Consistent with that observation, the same survey that Tinkelman and Lukowski cite with alarm shows that smoking among teenagers fell as vaping rose.
Tinkelman and Lukowski complain that the marketing of these products clearly has been developed to glamorize vaping and attract young people, which they say cannot be tolerated by society. The term young people, which could refer to chain smoking 25 year olds as well as tobacco naive 13 year olds, is perhaps deliberately ambiguous. But the bottom line is this Without all that intolerable marketing (a.k.a. speech), fewer cigarette smokers will be aware of a competing product that could literally save their lives. Tinkelman and Lukowski would sacrifice the health of actual smokers in the name of saving imaginary young people who never would have started smoking if they hadn t experimented with e cigarettes in high school.
The main argument for prohibiting vaping along with smoking is that it looks too much like the real thing. That resemblance, of course, is what makes e cigarettes such a promising harm reduction tool
Similarly, Tinkelman and Lukowski praise New York, Boston and Los Angeles for taking admirable steps to regulate e cigarettes. Those steps include treating vaping the same as smoking, meaning that e cigarettes are banned wherever conventional cigarettes are, even though there is no evidence that e cigarette vapor poses a hazard to bystanders. Since that policy eliminates an important advantage of switching from smoking to vaping, it could ultimately result in more tobacco related disease and death, which is not an outcome that should be welcomed by people who run a smoking cessation program.
The main argument for prohibiting vaping along with smoking is that it looks too much like the real thing. That resemblance, of course, is what makes e cigarettes such a promising harm reduction tool, since they mimic smoking while avoiding the toxins and carcinogens generated by tobacco combustion. But opponents of e cigarettes worry that public vaping will sow confusion among adults charged with enforcing smoking bans, and among children who might mistakenly think cigarettes aren t so bad after all. Those hypothetical problems seem overblown to me, but I will concede this much E cigarettes definitely sow confusion among anti smoking activists.
National Post
Jacob Sullum, a senior editor at Reason magazine, is the author of For Your Own Good The Anti Smoking Crusade and the Tyranny of Public Health (Free Press).