Commentary

Up in Smoke: CVS, Cigarette Sales, and a Changing Paradigm

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Without reading too much into CVS’s decision to stop selling cigarettes by October 1st (they may lose a small percentage of their profits, but have already gained exponentially in publicity), I will say that it echoes a message that health care providers have been proclaiming loudly for a long time: It makes no sense for a health-related business to sell tobacco-related products.

In time, I think we’ll come to see this announcement as a watershed event in the fight against Big Tobacco, setting off what I hope will be a trend in that direction on the part of all other drug stores, then grocery stores and other tobacco outlets. No, this won’t stop smokers from getting their fix, but it makes it a bit more difficult—and perhaps more importantly, it makes smoking just a bit less socially acceptable. We’ve known for years that this is what we need: for smoking to be out of fashion, to be seen for exactly what it is—a useless, dangerous, nasty addiction with absolutely no upside.

I never thought I’d live long enough to see this happen. But in 2000, a major college stadium where I was attending a football game (along with 85,000 others), had just been declared a no-smoking zone by the university. One man, who apparently hadn’t gotten the news, lit up during the game. Immediately, the security people were there to make him put out his cigarette. The other fans—myself included—actually applauded. I knew right then that as a society, we had turned a corner.

Now, most hospitals are smoke-free zones. I was part of that effort and, believe me, as obvious as that concept is, it was a struggle to achieve. Most businesses and other public gathering places are nonsmoking now, too. This movement is picking up steam, and it’s high time it does. But to fully appreciate where we are, you have to know where we’ve been.

I go back to a time when everybody smoked everywhere. Almost 60% of American adults smoked. Clinic waiting rooms had ashtrays by every chair. The receptionists and nurses smoked, and when the doctor came in the exam room to examine you, chances are, he would smoke during the exam! He would smoke (as could nurses and patients) in the hospital as well. It was just an accepted part of society.

But think about that for a minute: Suppose there was no such thing as smoking. Imagine that someone came along with that as a new idea.

“Let’s see: I want to take this cured vegetable leaf that I’ve chopped up into tiny slivers, and wrap it with thin paper. Then I want to set fire to the end of it, place the other end in my mouth, suck the smoke out of it, and breathe it into my lungs, where it will burn and most likely make me cough. The chemicals in the smoke will make my heart race initially, but then it will have the effect of a depressant. The first 100 or so times I do this, I will become nauseated, and may even throw up. But then those effects lessen, and before you know it, I feel very uncomfortable if I don’t smoke.”

“In fact, I begin to crave it so strongly that the next thing I know, I’m smoking 20 cigarettes a day. When I try to stop, I go crazy, so I keep smoking despite the fact that I’m paying $50 to $60 per carton—taking money away from my family, stinking up my whole house, my own body, and my breath, ruining my own health as well as my teeth, putting my family at risk as well, and getting nothing positive in return.”

Such a product would never get off the ground, legal or not. No one would be dumb enough to do it. Yet here we are in the 21st century, where smoking is, by far, the biggest preventable health problem in this country. It kills almost 450,000 Americans a year and cripples far more than that. And we finally have one major chain of drugstores announcing they will no longer sell cigarettes. It’s just another brick in the wall.

Have a comment? Email CRnewseditor@frontlinemedcom.com

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