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Chain accelerates movement toward ‘denormalization’

The Indiana University Richard M. Fairbanks School of Public Health and Indiana University School of Medicine applaud CVS/Caremark for its decision to remove tobacco products at all pharmacy locations across the U.S., more than 7,600 nationwide, including nearly 300 stores in Indiana.

This decision will reduce the availability of cigarettes and other tobacco products and send an unmistakable message to all Americans, especially children, that tobacco use is uniquely harmful and socially unacceptable. Policies that restrict access to tobacco products, reduce exposure to tobacco advertising and limit the places that people smoke have a direct effect on reduced smoking rates, especially among youth.

We commend CVS leaders for their decision to prioritize the health and well-being of customers and employees and for helping create a tobacco-free generation of youth. We urge other retailers, whether they have pharmacies or not, to join in efforts to help reduce access to tobacco, and eliminate tobacco-caused addiction, deaths and disease.

The CVS decision is based on sound evidence. Studies show that decreasing the density of tobacco outlets in communities decreases the use of tobacco products and likely decreases smoking rates among youth. As retail pharmacies stop selling tobacco products, they are “denormalizing” tobacco use, a critical step in shifting attitudes and behaviors among youth to be smoke free and make other healthy choices.

Science shows that this “denormalizing” process is a critical step in tobacco use prevention and encourages adults to stop smoking – a decision that has measurable health benefits in only a matter of weeks. Eliminating tobacco sales in pharmacies has long been advocated by health professionals, including the majority of pharmacists, the American Medical Association, American Heart Association and American Cancer Society. Some individual communities have banned such sales in pharmacies.

The timing of the CVS announcement comes just weeks after the 50th anniversary of the historic first surgeon general’s report, which concluded that cigarette smoking causes lung cancer, and a new surgeon general’s report that calls for a renewed focus on the numerous preventable causes of death and disease, including nicotine addiction; lung cancer and other cancers; chronic obstructive pulmonary disease; heart disease and stroke; reproductive diseases in women; premature births and ectopic pregnancy; hip fractures; male sexual dysfunction; blindness; congenital defects; pneumonia; diabetes mellitus; rheumatoid arthritis; and smoking-related fires and burns.

Almost half a million Americans die each year from using tobacco, and its use is a pediatric epidemic, as 90 percent of adult smokers began at or before age 18. Unless current trends are reversed, 5.6 million kids, including 151,000 Hoosier youths, alive today will die prematurely from a smoking-caused disease. Smoking-related annual costs in Indiana directly related to health care are $2.1 billion, with $487 million in the Indiana Medicaid program. Residents’ state and federal tax burden from smoking-caused government expenditures is $559 per household; and smoking-caused productivity losses in Indiana reach $2.62 billion annually.

Everyone has a stake in reducing tobacco’s terrible toll. One of the most effective ways to do this is to reduce access to tobacco products. In making this decision, CVS has recognized that selling tobacco products – the No. 1 cause of preventable disease and death – is inconsistent with its commitment to improving the health of its customers. CVS’ decision represents the bold leadership needed to accelerate progress against tobacco and ultimately end the tobacco epidemic for good.

Paul K. Halverson (left) is founding dean and professor at the Richard M. Fairbanks School of Public Health. Dr. Jay L. Hess is dean of the Indiana University School of Medicine. They wrote this for Indiana newspapers.