CVS ban on cigarettes could cut smoking rates

The decision by CVS to stop selling cigarettes could help to cut smoking rates substantially, especially because the move comes at a time of increased pressure on the tobacco industry from a number of fronts, health experts say.

"It is a big deal — one of those death knell events the tobacco industry has feared for some time," says Thomas Glynn, director of cancer science and trends at the American Cancer Society.

Research shows that making cigarettes even slightly less accessible has a measurable effect on smoking, especially for kids, who have fewer ways to get tobacco, says Otis Brawley, the Cancer Society's chief medical officer.

"It's an act of corporate courage," says Brawley, who says the Cancer Society has pressured pharmacies to ban cigarettes for several years.

Studies show that being forced to travel just two extra blocks can deter someone from buying cigarettes, Brawley says. Brawley notes that retailers have known for decades about the importance of positioning products near cash registers, to increase "impulse" buys.

Canada has reduced cigarette sales simply by requiring retailers to store them under the counter, where they're invisible to customers, says Richard Hurt, director of Mayo Clinic's Nicotine Dependence Center. He notes that tobacco companies pay convenience stores a lot of money to position cigarette ads prominently near the register. "The tobacco industry has known for decades that if they can place their products in customers' faces, they have more attractiveness," Hurt says.

Brawley says he hopes CVS' decision will pressure pharmacies such as Walgreens, which donates a lot of money to the Cancer Society, to also stop selling tobacco.

"If the cigarettes are right in front of you, if they're convenient, you are more likely to buy them," Brawley says. "This is especially true of people who are struggling to quit."

The CVS announcement comes amid a number of renewed efforts to combat smoking, including some timed to coincide with! the 50th anniversary of the first Surgeon General report on smoking.

• The Food and Drug Administration on Tuesday announced a $115 million anti-smoking campaign. On Monday, the Centers for Disease Control and Prevention began its third round of anti-smoking ads. Over the past two years, the CDC has spent $162 million on the ads, called "Tips from Former Smokers," which have been credited with helping 100,000 Americans quit smoking. This summer, the American Legacy Foundation will launch the latest version of its "truth" campaign, which has been credited with preventing 450,000 kids from becoming smokers from 2000 to 2004.

• A Surgeon General report on smoking last month estimated that tobacco kills 480,000 Americans a year, for a total of 20 million Americans in the past 50 years. In addition, 5.6 million children will die of smoking-related illness unless the country takes immediate action.

• Tobacco companies last month reached an agreement with the Justice Department on publishing corrective statements that say the companies lied about the dangers of smoking. The long-awaited advertising campaign was ordered in 2006 by U.S. District Court Judge Gladys Kessler, who found tobacco companies guilty of violating civil racketeering laws and lying to the public about the dangers of smoking and their marketing to children. Because tobacco companies are still appealing part of that ruling, and Kessler has to sign off on the ads' final language, it could take another year or two before the ads actually appear, says Matthew Myers, president of the Campaign for Tobacco-Free Kids.

• Lawmakers in Kentucky, which has the nation's highest adult smoking rate, at 28%, are considering legislation this week to make workplaces smoke-free. "Momentum is strong" to pass the bill, which has the support of Kentucky's governor, says Bronson Frick, spokesman for Americans for Nonsmokers' Rights. Twenty-six states and Washington, D.C., now ban smoking in indoor public places.

Some question! how much! impact CVS' decision will have.

Jerome Reisman, a senior partner at Reisman Peirez Reisman & Capobianco, a law firm in Garden City, N.Y., predicts the tobacco ban will have a "small financial impact on retail sales." Euromonitor International, which tracks industry trends, reports that pharmacies sold fewer than 4% of all cigarettes sold in 2012.

David Howard, a spokesman for R.J. Reynolds Tobacco, says: "We value the long-term relationship we had with CVS and respect their commercial decision. We will work with them as they transition out of the tobacco category in the coming months."

CDC director Thomas Frieden.(Photo: Jeff Franko)

Thomas Frieden, director of the Centers for Disease Control and Prevention and a longtime anti-smoking advocate, notes that the tobacco industry still spends $8.5 billion on marketing each year. "They remain a very formidable enemy," Frieden says. "They are really trying to squeeze every last dollar out of the people they kill."

But Frieden also says the "days of the tobacco industry are numbered." He notes that a majority of Americans who have ever smoked (about 50 million) have already quit. Most of the country's 42 million current smokers want to quit, he says.

"There's growing momentum to resume the rapid downward course of smoking and thus the upward course of health," Frieden says.

Steven Schroeder, a professor at the University of California-San Francisco, says the country could do far more to combat smoking. Only two states, for example, meet the CDC's goals on spending for anti-smoking efforts, such as educational campaigns. "We're a long way from the endgame," Schroeder says. "But we are a lot closer."

Ending the tobacco epidemic takes "political will," says Stanton Glantz, a ! professor! at the University of California-San Francisco.

The White House "has the power to fix the tobacco problem in a few years, if they would just get off their behinds."