Recently we learned that CVS has decided to stop selling cigarettes in its stores. It may be time for other pharmacies to do so as well. The second paragraph of the Oath of a Pharmacist, which all pharmacists have taken, reads as follows: “I will consider the welfare of humanity and relief of human suffering my primary concerns.”
As a pharmacist and as an educator of pharmacists for over 40 years, I have seen thousands of students go into the profession with this principle instilled in them. When these students become pharmacists they indeed are concerned with the welfare of humanity and relief of human suffering, dispensing medications that cure diseases. At the same time, in the very pharmacies that these useful substances are being dispensed, at the next counter, a very different kind of substance is being dispensed — tobacco.
It is ironic that in very close proximity, the compounds that alleviate suffering are sold along with ones that cause so much suffering. I suppose the cynical view is that this is not a bad deal, that the pharmacy gets the patient coming and going.
I realize that it’s the clerks and not the pharmacists that actually sell the cigarettes and other tobacco products, but as I used to teach my students, we are the last bastion between our patients and the toxic chemicals that are drugs. The very fact that cigarettes and the toxic chemicals they contain (nicotine, carbon monoxide, hydrogen cyanide and benzene among others) are sold in the same venue as pharmaceuticals confounds our ability to protect our patients — which is the very reason for our being. It is extremely difficult to explain to non-pharmacists why these lethal products are sold in pharmacies.
At some point pharmacies will be universally banned from selling tobacco products as they already are in some parts of the country. But as health professionals we shouldn’t wait until we’re forced to do the right thing, the thing we’re sworn to do. Indeed, pharmacies should be sponsoring smoking cessation programs. We have a chance to get in front of this now, if for no other reason than enlightened self-interest.
I don’t know where we stand on the “most respected list of professions” — we used to be first, but I suspect we’re somewhat further down the list at this point. Showing that we truly care about our patients — as it says in the ads of some pharmacies — would go a long way toward regaining the number one position.
I have no illusions that cigarettes will be ever be generally banned — it didn’t work for alcohol, and doesn’t work for other drugs. But there is no need for pharmacies to profit from them, even if they are just used as a loss leader to get customers into the store. We should have no more to do with tobacco products than with any other disease-causing entity. It’s been suggested that, by the same reasoning, pharmacies shouldn’t sell candy. However, while candy may be unhealthy for some, it certainly doesn’t cause the tens or hundreds of thousands of deaths that tobacco does.
I am not naïve enough to underestimate the role of profit in the pharmaceutical business or the difficulty in making a profit by only filling prescriptions. So sell toys and greeting cards and auto supplies and even candy, but keep in mind the primary mission of pharmacists is to save lives, to have as their primary concern the welfare of humanity and relief of human suffering.