Smoke signals for public health

Earlier this week two things happened that stand to improve public health, save lives and reduce the strain on health care delivery. The first of these was an announcement by the drug store giant, CVS Caremark Corporation, that the chain would no longer sell tobacco products. The second was the rollout of a program by the Food and Drug Administration titled “The Real Costs” — of smoking.

CVS is the largest pharmaceutical retailer in the U.S. with 2012 sales hovering around $123 billion. In a press conference the retailer said that it will halt all tobacco sales in its 7,600 stores by Oct. 1. In a prepared statement, Larry J. Merlo, president and CEO of CVS Caremark, said: “Put simply, the sale of tobacco products is inconsistent with our purpose.”

This bold change comes on the heels of an important anniversary in the fight to stamp out smoking — the 50th anniversary of the first report by the U.S. the surgeon general linking smoking to illnesses such as lung cancer and heart disease. As the Los Angeles Times newspaper observes: “Pharmacies have faced years of criticism from health advocates for juxtaposing tobacco items with medical products.”

This move is also part of an effort by CVS to position itself as a “healthcare” company rather than a convenience store that fills prescriptions. Accordingly some industry experts deride the change as less about altruism and more of a savvy shift in business model.

“It’s smart business on CVS’ part,” said Carl Tobias, a law professor at the University of Richmond in Virginia, told the Times.

This observation seems somewhat paradoxical given that CVS will sacrifice over $2 billion in annual revenue when it stops selling tobacco products.

Health and Human Services Secretary Kathleen Sebelius applauded CVS’ policy change. “Nearly 500,000 Americans die early each year due to smoking, and smoking costs us $289 billion annually,” she said. “Each day, more than 3,200 youth under age 18 in the United States try their first cigarette and more than 700 kids under age 18 become daily smokers. If we fail to reverse course, 5.6 million American children alive today will die prematurely due to smoking. This is unacceptable.”

Sebelius’ comments also provide a bridge to the FDA’s new “The Real Costs” initiative. Mitch Zeller, director of the FDA’s Center for Tobacco Products, said the campaign will target the 10 million young people ages 12-17 who are open to trying smoking or who have already smoked between one puff and 99 cigarettes in their lifetime.

Zeller further notes: “More than 3,200 young people age 19 and younger under age 18 smoke their first cigarette every day in the United States — and another 700 become daily smokers. FDA sees a critical need for targeted efforts to keep young people from starting on this path.”

The public education campaign is not funded by U.S. tax dollars — user fees collected from the tobacco industry fund all FDA’s tobacco-related activities, including educating the public about the harms of tobacco use, Zeller said.

Hopefully, these two efforts signal an important watershed in American culture. It’s time that we as a nation stop using tobacco products. We should stop, not because the “gub’ment” tells us to stop. We should stop because it’s in our own best interests. Smoking-related disease creates an enormous burden and bottleneck for public health. It kills people. It ruins families. It makes our country less than it could be. It time Americans stop being ruled by a nasty habit.