A drugstore quits cigarettes

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

CVS Pharmacy, a national drugstore chain, stopped selling cigarettes last week. This was big news because it was so unusual. And if anyone is wondering why the United States is spending far too much money paying for health care that isn’t making Americans healthier – those first two sentences should help explain it.

The chain is rebranding itself as “CVS Health” as it empties its shelves of the tobacco products that contribute to one in five American deaths, according to the Centers for Disease Control and Prevention (CDC). The company did not have a sudden epiphany that tobacco is bad for us. It’s trying to find a market niche as a health care provider. Like other pharmaceutical retailers, it also is offering basic medical services such as flu vaccines and blood pressure tests.

This is a welcome change because drugstores – which supposedly sell us products to make us well – are among the unhealthiest retailers in the country. The national chain in my area – I won’t use the name, but it’s new slogan contains the word “healthy” – sells cigarettes, candy and colas behind or near the cashier, who is located only feet from the doorway. Rows upon rows of candy, in fact, are sold in that store, along with chips and other salty snacks. It does sell cereal, and there’s a small refrigerated section that contains juice and milk, along with frozen pizza and ice cream. The gas station that changes my oil sells bananas, oranges and apples. Not so this drugstore, where virtually every grocery item is a processed food. The drugstore does sell bottled water, which, though a waste of money, is at least good for you.

You can’t really blame the drugstores for this. I guess they have every right to sell us what we have every right to buy, and Americans in general and Arkansans in particular buy a lot of tobacco, candy and processed foods. According to the CDC, an estimated 41.1 million Americans, or 18.1 percent of us, smoke cigarettes. In Arkansas, it’s 27 percent, ranking the state 49th, and not in a good way. More than one-third of Americans are obese.

The United States spends about 18 percent of its gross domestic product on health care – far more than other industrial countries. Some say it has the “best health care system in the world,” and if you judge it by one metric – the ability to treat certain serous diseases, that’s true. But it’s burdening us and future generations with unsustainable debt, and was doing so long before Obamacare was created.

The health care system itself is partly to blame. Among its biggest problems is that it rewards all the wrong behaviors. It pays medical providers far more money for treating diseases than it does for curing them and pays them almost nothing for prevention. A pharmacy selling us cigarettes and then selling us drugs (and charging the government for them) to treat the effects of those cigarettes? That’s the American way.

But just as it’s very hard for schools to educate students without parental support, it’s difficult for the health care system to treat patients when we don’t treat ourselves. Americans see “health care” largely as the act of taking a pill, right now, to make us feel better, right now. It’s no wonder drugstores sell cigarettes and candy. They’re drugs. One produces a nicotine high, and one produces a sugar rush.

So while we’re talking about state and national policies, we also have to talk about personal responsibility. In fact, the conversation must start there, even if it’s a little uncomfortable, just as writing this column has been. (Most are.) As Arkansas Surgeon General Dr. Joe Thompson said recently as we discussed various forms of health care reform, “If we don’t get control over our obesity and of our hypertension and our tobacco use, it doesn’t matter how much money we’re spending. We’re going to sink the boat.”

Will a drugstore clearing its shelves of America’s most harmful drug keep that boat afloat? No, but it certainly can’t hurt. It made its choice based on free market principles. Let’s hope the market rewards it, and that others freely follow its lead.

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