The decision by CVS/Caremark to stop selling tobacco products by October signals another step by the country’s second-largest drugstore chain to be more of a health care provider, offering more mini-clinics and health advice for customers visiting its pharmacies.
While the company’s decision, announced Wednesday, will cost it an estimated $2 billion in sales from tobacco buyers, that is a mere dent in its overall sales of $123 billion in 2012.
“We have about 26,000 pharmacists and nurse practitioners helping patients manage chronic problems like high cholesterol, high blood pressure and heart disease, all of which are linked to smoking,” said Larry J. Merlo, chief executive of CVS. “We came to the decision that cigarettes and providing health care just don’t go together in the same setting.”
Some major retail stores like Walmart and convenience stores still sell cigarettes and other tobacco products, although anti-smoking groups and health care professionals will probably use CVS’s decision to try to pressure others to consider doing so. Municipalities have also begun enacting legislation governing where cigarettes can be sold.
Kathleen Sebelius, secretary of health and human services, said in a statement that the CVS decision was “an unprecedented step in the retail industry” and predicted it would have “considerable impact.”
Sebelius said that each day, some 3,200 children under 18 will try a cigarette and 700 will go on to become daily smokers. That means, she said, that 5.6 million American children alive today will die prematurely due to diseases linked to smoking.
“Today’s CVS/Caremark announcement helps bring our country closer to achieving a tobacco-free generation,” she said.
CVS does not sell electronic cigarettes, the highly popular but debated devices that deliver nicotine without tobacco and emit a rapidly vanishing vapor instead of smoke. It said it was waiting for guidance on the devices from the Food and Drug Administration, which has expressed interest in regulating e-cigarettes.
When San Francisco first proposed banning the sale of tobacco products in pharmacies in 2008, the Walgreen Co. sued, contending it was unfair to place such restrictions on drugstore operators and not on grocery and discount stores with pharmacies inside.
Two years later, the city came back with a ban that included all stores with embedded pharmacies. That prompted retailers like Safeway and Costco to stop selling cigarettes in their stores with pharmacies.
A number of municipalities in Massachusetts, including Boston, have similar bans in place, a few of which also include prohibitions on the sale of e-cigarettes.
Otis W. Brawley, chief medical officer at the American Cancer Society, said other local government entities were weighing similar measures.
“If you’re in the business of promoting health and providing health care, it’s very hypocritical to be selling tobacco products,” Brawley said. “It just doesn’t make sense and in fact is almost a conflict of interest.”
And as for driving away customers to competitors, Troyen A. Brennan, the executive vice president and chief medical officer for CVS, said: “It’s obvious that the average person will just find somewhere else to buy cigarettes. What we’re thinking about is if others want to emulate this business decision we’ve made, then over time that will make cigarettes less available — and scientific literature does suggest that a reduction in the availability of cigarettes reduces smoking.”
Brennan, together with Steven A. Schroeder of the Smoking Cessation Leadership Center at the University of California, San Francisco, wrote an op-ed article making the case for eliminating tobacco products from drugstores in the Journal of the American Medical Association published online Wednesday.
Some 18 percent of U.S. adults smoke, down from 42 percent in 1965. In places like New York City, which has used a combination of steep taxes on cigarettes and bans on smoking in most places to discourage smokers, the decline is even greater, down to 14 percent.
But health experts remain concerned because the rate of decline has stagnated over the last decade, and some 480,000 deaths each year are linked to smoking. From 1999 to 2003, for example, the smoking prevalence among high school girls dropped 37 percent, according to the Centers for Disease Control, but from 2003 to 2007, the decline was only 2.3 percent.
CVS hopes to make up some of the lost revenue and income with a smoking cessation program that it is starting this spring with the goal of getting half a million Americans to stop smoking.
“This is a great example of how we’re evolving from a retail company to a health care company,” said Helena Foulkes, executive vice president for CVS. “This is the kind of offering we can bring to clients like insurance plans and companies, many of which will pay for such a program.”