
CVS Caremark pharmacies to halt tobacco sales - kenshiro_o
http://www.bbc.co.uk/news/world-us-canada-26051519
======
gatehouse
One interesting thing I picked up from Damian McBride's political memoir was
that the most progressive (in the taxation sense) change that they could make
to the VAT would be to lower the taxes on cigarettes and alcohol.

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onion2k
Here in the UK the only shops that sell cigarettes are supermarkets and
independent newsagents, and neither is allowed to have them on display -
they're on shelves behind the counter with shutters or curtains in front. Some
bars have vending machines for them, but even that's becoming quite uncommon.
I imagine within a decade supermarkets will have stopped selling them
altogether so the few remaining smokers will have to hunt out little
backstreet shops that still stock them.

To learn that cigarettes are sold in _pharmacies_ in the USA is frankly
incredible.

~~~
meddlepal
In the US, Pharmacies are basically just convenience stores with an actual
pharmacy/prescription pill-dispensary in the back. Not sure what they are like
in the UK, are they more formal?

~~~
davb
In the UK, pharmacies sell pharmaceuticals, healthcare, beauty and toiletry
products.

I was really surprised when I last visited the US to find a pharmacy with a
deli counter, electronics aisles and a fridge full of frosty beers. It really
was just a slick, well-stocked convenience store.

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tzs
Good move for CVS. A rational clear case can be made that a pharmacy should
not be selling products whose primary use is subversion of our health. The
notion is in fact rather bazaar. It perforce sends a bad message when a store
operating under the aegis of a state license to sell medicine sells something
as bad for you as cigarettes.

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jack-r-abbit
While I applaud the stand they are taking against this killer product, it does
seem a bit hypocritical that they will continue to sell junk food and liquor.

~~~
cheald
I agree, they should do a full rebrand and only sell organic kale and granola.

~~~
viraptor
Or not take it to any extreme and just remove the most unhealthy products?
Possibly replacing them with something on the healthy side of "neutral",
without going into "only organic" craze either.

~~~
cheald
What are the "most unhealthy" products, exactly? Where do you set the bar?

~~~
MrZongle2
Well that's the problem, isn't it?

 _The bar never stops moving._

Today, it's cigarettes. Tomorrow, it's e-cigarettes. Then it's sugary sodas.
Then cookies.

Eventually, the store sells tofu and free-range cotton balls.

~~~
cheald
Not just that it never stops moving, but that it's arbitrary. What I consider
unacceptably unhealthy is entirely different from what you may consider
unacceptably unhealthy. My original point was that if we're going to eliminate
all the unhealthy things, we might as well just keep going until we're all
buying nothing but raw vegetables.

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hairama
This could mean that they're moving the cigarettes from the pharmacy proper,
to the regular retail area--with a healthy amount of spin.

~~~
jack-r-abbit
I'm pretty sure they've always been behind the checkout counter. Most (all?)
stores that sell smokes keep them somewhat guarded to prevent people
(particularly minors) from stealing them.

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christopheraden
My first question was how CVS-Caremark, a publicly traded company would be
allowed to do this, considering it would hurt their bottom line. I didn't
think ethics were a reasonable excuse for knowingly hampering profits, unless
they felt there was some long-term benefit to their business of not selling
cigarettes. Fiduciary duty trumps morals.

Does it have anything to do with the fact that CVS-Caremark is one of the
largest PBMs in the US (second only to ExpressScripts, actually)?

There's more at play here than just a moral action.

~~~
colinbartlett
Public companies do not have a "fiduciary duty" to put profits ahead of
morals. Whatever made you think that was the case?

Executives are beholden to the board who is beholden to the shareholders. If
the shareholders don't want this, they can force change at any level.

~~~
wbrendel

      Whatever made you think that was the case?
    

Probably because public companies frequently use this as an excuse for their
immoral business practices. Examples? Basically any health insurance company
in the US.

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cma
lifehacker.com to continue interspersing Gawker and Jezebel story links
amongst treatises on focus and productivity.

~~~
doktrin
Huh?

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taternuts
probably because they are making enough money selling e-cigs to make up for
it.

~~~
rm999
CVS has always refused to sell e-cigs, as I understand it. They certainly
don't right now.

edit: just found this:

>CVS does not sell electronic cigarettes, the highly popular but debated
devices that deliver nicotine without tobacco and emit a rapidly vanishing
vapor instead of smoke. It said it was waiting for guidance on the devices
from the Food and Drug Administration, which has expressed interest in
regulating e-cigarettes.

source: [http://www.nytimes.com/2014/02/06/business/cvs-plans-to-
end-...](http://www.nytimes.com/2014/02/06/business/cvs-plans-to-end-sales-of-
tobacco-products-by-october.html)

~~~
taternuts
Cool, I just assumed they sold e-cigs - thanks for the correction.

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icantthinkofone
In this day and age, I am continually astounded that people smoke and take up
smoking.

~~~
nawitus
I'm not. Smoking a little (e.g. 1 cigarette a day) is inexpensive, has very
little harmful effects to your health but allows you to enjoy the cultural
experience of that particular drug.

For some reason people these days think that it's pretty much okay to drink a
lot of alcohol which is very expensive and very unhealthy, but if someone
smokes here and there it's "crazy", "stupid" and "very expensive".

Nicotine itself has plenty of beneficial effects:
[http://www.gwern.net/Nicotine](http://www.gwern.net/Nicotine)

~~~
DanBC
(I accidentally downvoted you. Sorry.)

Buying cigarettes means giving money to tobacco companies. I firmly believe
these are an example of corporations bein evil - which I understand is a
controversial opinion on HN.

The tactics (spread fear and misunderstanding; discredit your oponents) have
been taken up by other campaign groups (eg, anti climate change groups) often
using the same scientists for hire.

"Vaping" avoids most of the social stigma of smoking and if you buy carefully
you avoid giving money to tobacco companies.

~~~
eli
I think there's still a pretty significant stigma against smoking an e-cig in
public, but I guess YMMV.

~~~
DanBC
I agree. I like the fact that some people are careful about where and when
they "vape" \- not in feont of children, not around people eating etc etc.

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a8da6b0c91d
Tobacco does have some well documented medicinal qualities, believe it or not.
There's no shortage of things at CVS that can harm through abuse.

~~~
cheald
Nicotine has a lot of really great qualities, but anyone trying to justify
smoking or chewing tobacco for its _medical_ benefits is in denial.

~~~
a8da6b0c91d
There are a lot of people who have found that one or two cigarettes a day
keeps depression at bay. There are biochemical reasons to believe them. Who
are you to tell them they should have to get a prescription SSRI?

~~~
cheald
That would be the nicotine stimulating the release of glutamine and dopamine.
The value there is in the nicotine, not in the tobacco. You can get nicotine
separately from tobacco trivially.

The false choice of cigarettes or SSRIs is silly.

~~~
a8da6b0c91d
It's not just nicotine. Tobacco smoke has compounds like beta-globulines that
lower serotonin and estrogen. There are also arguments that low doses of
carbon monoxide can have therapeutic affects.

~~~
cheald
...but reduced serotonin levels are linked to depression. The entire point of
SSRIs is to keep your serotonin levels higher and thus improve synaptic
signalling. Wouldn't reducing your serotonin production be bad?

Edit: Here's a link to a cross-sectional study showing a cause-effect
relationship between smoking and depression.
[http://bjp.rcpsych.org/content/197/5/413.full](http://bjp.rcpsych.org/content/197/5/413.full)

~~~
a8da6b0c91d
That's a point of debate, actually. SSRIs in the long term appear to actually
work by reducing serotonin in the brain tissues.

Serotonin is really more of a torpor hormone that depresses the whole body
than a "happy" neurotransmitter. It's associated with hibernation, for
example. The "turkey causes sleepiness" meme is about tryptophan in the meat
boosting serotonin levels.

