Tobacco-free pharmacy

Tobacco display in a Hollywood branch of Walgreens; displayed on the left are Nicorette smoking cessation products. Anti-smoking campaigners may regard this as a contradiction, while pharmacies state that they are offering smokers stop-smoking products at the point of sale

Tobacco-Free Pharmacies is a term used to refer to retail pharmacies where the sale of tobacco products is not available. In the United States, it is common for pharmacy stores to sell cigarettes and similar products on the same premises as over-the-counter drugs and prescription medication. Campaigners in the USA advocate the removal of tobacco from pharmacies due to the health risks associated with smoking and the apparent contradiction of selling cigarettes alongside smoking cessation products and asthma medication. Pharmaceutical retailers counter this argument by reasoning that by selling tobacco, they are more readily able to offer to customers advice and products for quitting smoking.

San Francisco was the site of the first ordinance ever passed in the United States to prohibit the sale of tobacco products in pharmacies. The ordinance was introduced on April 29, 2008 by Mayor Gavin Newsom, passed the San Francisco Board of Supervisors on July 17, 2008 by a vote of 8-3, and took effect on October 1, 2008. On that date, pharmacies in the city became tobacco-free based on passage of Ordinance 194-08, which revised the San Francisco Health Code by amending Section 1009.53 and adding Section 1009.60 and Article 19 J. The ordinance denies the issuance of a tobacco retailer license to any establishment defined as a pharmacy. The definition of pharmacy at that time included independent pharmacies and drugstores such as Walgreens; however, exemptions were allowed for grocery stores and big box stores such as Safeway and Costco that had pharmacies. Introduction of the tobacco-free pharmacy ordinance received a fair amount of media attention, throughout California and the nation. Nathan Ballard, Mayor Newsom’s Communication Director, was quoted as saying “A pharmacy is a place you should go to get better, not to get cancer”. The ordinance generated a fair amount of controversy. While advocates ran a visible campaign with the theme “Cigarettes and Pharmacy Don’t Mix”, Walgreens opposed the proposed ordinance, going so far as to post fliers on the cigarette racks in its stores.

Legal challenges

On September 24, 2008, just before the tobacco-free pharmacy ordinance was to take effect, Philip Morris USA, Inc. filed suit against the City and County of San Francisco in United States District Court. Attorneys for Philip Morris argued unsuccessfully that the ordinance “forced the tobacco company to pull its advertising out of drugstores, interfering with its constitutional right to communicate with its customers”. In addition to the lawsuit from Philip Morris, on September 8, 2008, Walgreens had more success when it sued the City and County of San Francisco in Superior Court of the State of California, claiming “unconstitutional discrimination” because the Walgreens location would not be allowed to sell cigarettes under the new ordinance whereas grocery and big box stores with pharmacies would be allowed to continue to sell. After a number of legal appeals, Walgreens won the upper hand, with San Francisco ultimately deciding not to appeal.

Broadening of the Tobacco-Free Pharmacy Ordinance

Ad campaign against the sale of tobacco products in pharmacies, San Francisco, June 2008

With lawsuits from Philip Morris and Walgreens now behind them, the City and County decided to revisit the ordinance with an eye toward broadening it in a way that would even the playing field for all pharmacies. A new ordinance was introduced on August 3, 2010 by San Francisco Supervisor Eric Mar that would remove the exemption for big box stores and grocery stores. On September 13, 2010, a public hearing was held in front of the Land Use and Economic Development Committee. Speakers in favor of the broadened ordinance included Director of Public Health Mitch Katz as well as representatives from the California LGBT Tobacco Education Partnership, Pharmacists Planning Service, Inc, UCSF School of Pharmacy, the American Heart Association, American Cancer Society and the San Francisco Tobacco Free Coalition. Speaking to oppose or to delay the proposed ordinance were representatives from the Office of Small Business and Charlie’s Drug Store. Safeway did not speak at the hearing but spoke out against the ordinance in the press, stating "We certainly are not promoting tobacco use, but we do believe there's a freedom-of-choice issue..." The new, broader ordinance passed the Board of Supervisors on September 21, 2010. Safeway and Costco promptly removed all tobacco products from the shelves in their stores that have a pharmacy.

Tobacco-free pharmacy policies in other communities

After San Francisco passed its initial policy, a number of other communities followed suit. These include Acton, Arlington, Ashland, Barnstable, Barre, Bedford, Boston, Brewster, Brookline, Buckland, Chatham, Concord, Dartmouth, Everett, Fairhaven, Fall River, Falmouth, Fitchburg, Gardner, Gill, Gloucester, Harwich, Hatfield, Haverill, Lancaster, Lee, Lenox, Leominster, Lowell, Malden, Melrose, Middleboro, Middleton, Needham, Montague, Newton, New Bedford, North Attleboro, Oxford, Pittsfield, Reading, Revere, Rochester, Salem, Saugus, Somerville, Southboro, Springfield, Stockbridge, Wakefield, Walpole, Wareham, Watertown, Wellesley, West Boylston, West Springfield, Westford, Westwood, Westport, Whately, Winchester, Worcester and Yarmouth Massachusetts and in California, Richmond and the unincorporated area of Santa Clara County. Companies affected by the policies in California and Massachusetts include Big Y Supermarket, Brooks, Costco, CVS, Hannaford, Kmart, Lucky Supermarkets, Price Chopper, Rite Aid, Safeway, Shaw's, Star Market, Stop & Shop, Walgreens, Walmart and various independent pharmacies. A number of the Massachusetts municipalities listed extend the tobacco sales ban in pharmacies to include the sale of "nicotine delivery products", including electronic cigarettes. "Nicotine delivery products" are defined as manufactured products that contain nicotine, but not tobacco, and are not FDA approved.

Canada

Smoking bans have been implemented across Canada. The 2008 ban in Alberta required pharmacies, or retailers with a pharmacy department, to confine tobacco sales within segregated areas or kiosks. The Canadian drug store chain London Drugs announced that it would withdraw tobacco sales rather than invest in store alterations to comply with the new law, and Safeway only installed kiosks at two outlets after a similar ban in Ontario in 2006. The Canadian retailers also defended the practice of pharmacy tobaccos sales with the argument that they could offer smoking cessation products directly to smokers at the point of sale, citing a large drop in stop-smoking aids following the ban.

See also

• History of commercial tobacco in the United States
• Regulation of tobacco by the U.S. Food and Drug Administration
• Retail display ban
• Tobacco in the United States
• Tobacco harm reduction

External links

• California LGBT Tobacco Education Partnership
• Americans for Nonsmokers’ Rights
• Tobacco Free Pharmacies