On the heels of CVS Health’s 1-year anniversary of stopping tobacco sales, a viewpoint provides a detailed history of the “long, cozy” relationship between drugstore chains and tobacco companies.

While all leading drugstore chains have traditionally sold tobacco products, CVS has made several efforts to distance itself from this practice, authors David Tuller, DrPH, and Lisa Bero, PhD, noted.

Beyond stopping the sale of tobacco products and rebranding itself as CVS Health, the pharmacy giant announced in July 2015 that it would leave the US Chamber of Commerce because of the organization’s global efforts to block antismoking laws, such as putting taxes on cigarettes in the Philippines.

Before CVS’s September 2014 decision to stop tobacco sales, leading drugstore chains not only sold cigarettes, but also collaborated with tobacco companies, Drs. Tuller and Bero noted.

Their review of memos, letters, and reports from the Legacy Tobacco Documents Library uncovered evidence of tobacco companies and pharmacies working together to mold public attitudes toward smoking and fight regulatory efforts.

Tobacco companies have showed an interest in selling their products in pharmacies specifically because of the potential for high consumer traffic.

Drugstore chains have also tactfully set up point-of-purchase tobacco product displays after recognizing how profitable they are. (CVS Health expects a $2 billion loss because of its end to tobacco sales.) 

“Now that pharmacies also sell a proliferating number of smoking cessation products, they face even greater charges of hypocrisy and conflict of interest,” the authors wrote.

Meanwhile, many independent pharmacies refuse to sell tobacco products, and some pharmacy associations have called for an end to tobacco sales in all pharmacies. In San Francisco, California, pharmacies cannot sell tobacco or e-cigarettes.

Nevertheless, Drs. Tuller and Bero criticized pharmacies’ “aggressive” marketing of tobacco after the Surgeon General’s 1964 report, which determined that smoking was associated with higher mortality. The authors also called for legislative action to prohibit pharmacies from selling tobacco products.

“Now that CVS has taken the first bold step, it is time to send all pharmacies a message: establishments that profit from tobacco should not be allowed to market themselves as providers of health care services,” they wrote.

Their viewpoint was published in JAMA Oncology.