Hand-Holding with the last tobacco banning post.

I really hate doing clue-bat entries, but from some of the comment/emails I have received regarding my previous post about tobacco sales in pharmacies some/most of you ‘don’t get it’.  Either I worded it wrong, or people just saw “Tobacco + Pharmacy + Stupid” and jumped to conclusions.

I’m not saying that pharmacies should sell smokes and other tobacco entries.  I think that if a pharmacy does that its not only unethical but retarded (however nobody has a problem with gas stations selling beer/liquor, go figure).

The issue that I thought I made clear in the last post was who gets to make the decision as to what LEGAL product you can and cannot sell in your store which is LEGAL in every other store.  Its not really about if a pharmacy should sell, but who gets to make that decision.  Now remember that Tobacco is a 100% LEGAL substance.  Yes it has no health benefits and is dangerous, but that’s not what I’m arguing about.

Now, personally, I should be able to sell whatever legal substance (that can be sold anywhere) I choose.  If I wish to sell tobacco and be a total hypocritical pharmacist douche, that’s my right.  Its also your right to not trade with me because of my choice in what I sell.  With me so far?

However SF now has drawn the line in the sand.  Since nobody really fought it, they have set precedence that the city can dictate what individual classes of businesses can and cannot sell.  Products that the GOVERNMENT not YOU have decided  “for the best interest of the public” cannot be sold in a business that YOU OWN AND RUN.  This is the start of SOCIALISM in pharmacy with decisions made by people who are NOT PHARMACISTS.

This is super bad news here.  You may think that allowing them to ban tobacco is nothing big, but replace tobacco with any of the following and you have Pharma-riots.

  • Birth control (if you’re so bent on pressing your religious beliefs on those who do not share the same views as yourself and would want to BAN something, then yes, you are a “shit-eating psycho religious type”)
  • Plan-B
  • Soda/Candy (see below)
  • Sudafed (as if putting that behind the counter did anything what-so-ever)
  • Anything that a combination of whining/money/politics can ban “for the children”.

Pharmacies in SF got bent over by the city, and given the dildo of justice on their rights.  The city is putting their nose in what you can and cannot sell, but ultimately has no responsibility if your business goes under.

If SF banned tobacco within the city limits for EVERYONE, this whole rant is a non-issue.  Everyone gets screwed, everyone is on an even playing field, SF sucks, move.  Nanny-SF says that you are too stupid to live your own life, no cancer-sticks for you.  But SF is selectively targeting pharmacies and preventing them from selling a legal product.  Like HIPAA, COMMON SENSE DOES NOT NEED TO BE PUT INTO A FUCKING LAW!!!!!  Now the socialism slope is greased up, how long until you must clear with the city what inventory you stock?

Here is the list that no pharmacies should carry (according to SF)
Tobacco

  • Lung Cancer
  • Mouth Cancer
  • Second Hand Smoke
  • Fetal damage

Sugar/Candy/Soda

  • Childhood obesity
  • Dental caries
  • Exacerbation of Diabetes
  • Caffeine Addiction

Pork Rinds

  • Lipid Disorder
  • Heart Attack
  • Stroke

Alcohol

  • Addiction
  • Liver Failure
  • Bad Dancing
  • UNWANTED CHILDREN
  • Fetal damage

See all of the above? NONE ARE 100% GUARANTEED TO HAPPEN.  Stop with the weak “tobacco is bad mmm-kay” arguments.  These are all on the “should not sell” list using the same rationale that SF did with banning tobacco.

Don’t say that I didn’t warn you when this case gets brought up and something that YOU care about stocking gets banned using this tobacco bullshit as a case study.  By the time that happens however the battle has already been long lost. 

I hope that clears up some confusion.  Go ahead, call me paranoid, laugh at me, but deep down you know that I bring up a damn good point.

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30 Comments

  1. TheBitterTech says:

    What irritates me the most about this, and I’m shocked that nobody else has commented on it, is that stores like Wal-Mart, Kroger, and the $4 generic pushing stores are exempt from this policy, and it only focuses on stores that are actually drugstores rather than “contain a pharmacy”
    If forcing PBM payouts to drop precipitously wasn’t bad enough, the big box store pharmacies are now getting an unfair advantage of the (annoyingly large) quotient of their patients who try to kill themselves and save themselves in the same purchase.
    Do you think corporate execs would be so willing to take a loss on medications if they had to cut out their cigarette sales to sell them? If I were a Walgreens/CVS in the area, much less and independent, I’d be damn close to rioting

  2. http://openid.aol.com/wolkenblitzer says:

    I fully agree with your argument it is exactly the same one I had with smoking bans. It is the government telling business owners how to run their businesses. This is particularly bad in city wide bans where patrons can just take their business to the next town or bar owners are inclined to ignore the laws to keep their business going.

  3. welsh pharmacist says:

    That arguement is also wrong? why cant the law making government decide what we can and cant sell. I’m not sure how it works over there, but there are very strict things on what grocery shops can sell, especially medicine-wise, for example the 100% legal pharmacy only medicines, i’m sure they would love to sell all them for a tidy profit margin. But they can’t thats how it is so its tough. Everything has control’s over it, alcohol and tobacco have age control’s, you need a license to sell alcohol. control by the government is normal.
    And by the way I think that gas stations selling alcohol is also dumb and should probably be stopped, but then there is possibly more reason for them to sell that than us to sell tobacco. I would never never drink and drive, but get all of my drink in my car at the local asda(our walmart)

  4. http://openid.aol.com/npage148 says:

    Comparing that list tobacco is the only one with zero healthy benefits. Alcohol, pork rinds, and candy when used in moderation has at least 1 health benefit. They can all be part of a healthy lifestyle. Name a health benefit from tobacco. Can you?

  5. jon rph says:

    Thanks for coming back to this TAP. I read some of the comments for the other post and a lot of those folks don’t understand your message. Several of those comments seemed to be coming from quasi-medical professionals who were stunningly eager to give up their rights which was equally scary. Let me try to rephrase your argument so they understand it better.
    IF THE GOVERNMENT TAKES AWAY YOUR RIGHTS AND MAKES YOUR DECISIONS FOR YOU, IT IS A BAD THING!! Period. End of argument. If you are a pharmacist, you need to understand that this is an example of the government substituting it’s own professional judgement for yours. THAT is the problem. If we let them get away with it, and we totally already have, we are opening the door for other issues in the future. Maybe your pharmacy can only stock fat free milk because the saturated fat clogs arteries; maybe you can’t carry makeup because those products create unrealistic expectations of beauty in women; etc.
    And back to smoking. For all of you pharmacists who think the SF smoking ban was a good idea, especially you retail folks, SHAME ON YOU. Here’s why: This ban WILL NOT keep people from smoking, WILL NOT keep young people from smoking, and WILL NOT benefit the public health in any way. The only thing it WILL do is drive customers away from your store to gas stations, grocery stores, or to the walmart pharmacies who were unaffected by the ban. Seriously, you guys need to wake up.

  6. http://openid.aol.com/nplumer says:

    This is how SF operates. They have a warped understanding of how the rest of the world conducts business. Walgreens owns the SF pharmacy market. I would just shut my stores down unannounced for a week or two just so the city realizes how they shouldn’t pick on specific business or else they leave town. Why any business owner would want to put their business there is beyond me. Relocate to Alameda or San Mateo Counties where the [barely] have a little more sense.

  7. RxDawg says:

    Opinoidsomethinganother said ” Name a health benefit from tobacco. Can you?”
    1. Ulcerative Colitis
    2. Take it out and its good for the swelling with wasp stings – ol’ grandma remedy.

  8. Cathy says:

    You do bring up a good point. If something is legal to sell without a license, it should be legal to sell anywhere.
    I think it might be funny if, instead of banning cigarettes from pharmacies, you could only buy them at pharmacies. With a prescription. I want to meet the doctors who will write prescriptions for cigs the way they hand out Vicodin. Will they always check the “no substitutions” box for Marlboros? Or can you give them store brand? Will insurance pay?
    Though, I guess, then you’d have to deal with a whole other class of addict trying to convince you to fill their prescription early.

  9. chase says:

    God Bless you.

  10. Mella says:

    I’m in Nova Scotia, Canada, and you haven’t been able to buy tobacco products in drug stores for a few years now. They’ve now gone so far as to restrict stores that are legally allowed to sell, by forcing them to have all products out of the view of minors, in cabinets or under the counter. This includes lighters.
    It’s ridiculous.

  11. Jon says:

    @http://openid.aol.com/npage148
    Please explain how candy provides any benefit to 99% people today. Most candy has no nutritional value other than providing calories which most Americans do not need any more of. I say ban candy, chips, pop,fatty meats, eggs, whole milk for pharmacies and stores that contain pharmacies if cigarettes are going to be illegal. Why also the double standard of having Walmart sell cigarettes while they promote their $4 rx’s and the benefits that Walmart provides. They are advertising themselves as pharmacy providers, so they should follow by the same rules as everyone else.

  12. BS '01PharmD '08 says:

    I agree with TAP on this issue….while I think it is crazy for apharmacy to be selling tobacco, I don’t think the government has the right to tell businesses what they can/cannot sell.

  13. Christine says:

    I think pharmacies shouldn’t be allowed to sell prescriptions that may have adverse effects.

    • phrex says:

      Christine says:
      February 11, 2009 at 3:09 pm

      I think pharmacies shouldn’t be allowed to sell prescriptions that may have adverse effects.

      That’s Brilliant! No potentially harmful substances allowed to be sold = nothing can be sold.

  14. NoCigs says:

    I have to say I’m quite amazed by the level of dialogue this issue has generated.
    It’s pretty easy to see that if someone felt the need to draft this law in the first place, there must be a lot of “hypocritical pharmacist douches” around that see nothing wrong with dropping a carton of cigs into the same bag holding a patient’s latest refill of chantix.
    Second, where is it written that you have an inalienable right to sell whatever you want? To me this is not an issue of rights, but rather the appearance of professionalism. I live/work in Canada, where an identical law has been in place provincially, if not nationally, for many years with none of the hand wringing and complaints about big brother that fill this site.
    Finally, the extrapolations you are making to try and prove your point are simply ridiculous. Cigarettes do not belong in an environment that is (supposedly) devoted to the pursuit of health because they are the leading contributor to morbidity and mortality in North America. If another product (somehow) comes along that is equally as dangerous, I am glad to know that my government will ensure that it is not sold in a healthcare setting, and really hope that those of you who are up in arms about this law will loosen your grip on the bill of rights, look north and realize that maybe a little bit of socialism in your health care system could actually be a good thing…

  15. SF wants to ignore federal, state and local laws to make up their own so they can complete their transformation into a completely socialist state.
    I say, fine, let them do as they wish. But no more federal money for anything you do, you’re on your own.
    Like that wonderful sanctuary city edict you’ve created. The next time one of these wonderful illegal aliens sneaks in, rapes your friend then stabs her three or four times, you can say, “Oh, its okay. Its not your fault.”
    SF can burn to the ground as far as I’m concerned.

  16. crimson_gal says:

    Welcome to the new communist America! Our founding fathers are turning over in their graves.

  17. Pharm boy says:

    I agree with NoCigs on several things. First, I work in the VA system which is much like “socialized” medicine. While in a few areas there are short (1 month or so) waits for non-emergency treatment, the VA system has been held up as a model for other healthcare systems to follow, with integrated access to patient info and many other aspects. The buying power we generate would astound you, and what we pay for medications are usually around 25-40% of what retail places, even as low as 10% in cases, from the same wholesaler. (My wife’s pharmacy uses the same wholesaler and I have compared.) Second, do you think medicaid/medicare leeches should be rewarded for bad behavior? having more kids to get a bigger check… leaving their kids’ Amoxil and getting their Norco? Well, it’s their right to do so, but they shouldn’t be able to do that crap while sucking the government’s teet, since they are sacrificing their “healthcare” for their own selfish benefit. You can continue to sell cigs, just give up reimbursement from the government! You no longer accept MA claims, those customers can go somewhere else, and you can sell cigs in your store! The government will take it’s hand out of your business (both saying what you can sell, and giving you that Medicaid business).
    I have loved your rants for a long time, and I usually agree with you, just sharing my opinion on this.

  18. Jon says:

    @nocigs.
    Some of the problem was that Walgreen’s, CVS, etc are the only ones affected while Wal-Mart who advertises the crap out of their pharmacy program can still sell them. They are a health promoting facility also, are they not? Also there is no health benefit to most candy, chips, pop, etc yet you have no problem selling them to obese people picking up their 5 diabetes medications at the age of 40? It’s also not about socialism in health care. When one business can sell it and another can not that’s not equality.

  19. Mary Augustine says:

    Still stand behind my disdain for the act of selling cigarettes in the pharmacy.
    Sorry, for all those rational diviners of US Constitutionality.
    I am interested, though, if in the Canadian localities there have been any long-term studies that show a change in smoking patterns, and ultimately less incidence of the side-effects of inhalation of polyaromatic hydrocarbons and nicotine addiction.
    Also, the point has been brought up about definition of pharmacy vs. drugstore. Some have brought up the issues of differences between retail stores that also sell pharmaceuticals and prescription drugs from other shops exclusively selling pharmacy items. What’s fair is fair, no matter what original legality.
    If there was a single grocery/drugstore in a remote area of the wilds of California (where is that?) in which the limiting of cigars would present a hardship to patients/customers, then this would be the place to contest the ruling, i.e. the pharmacy store might have legal grounds to sue for interference with livelihood (in the short term). But, on the other hand, perhaps there are analogous situations that would make the decision easier to understand e.g. Medicaid-funded Addictions Counseling Center located in a bar, or course at jr college to teach women how to be hookers.
    Also, the correlation between smoking and improved ulcerative colitis symptoms is weak enough to consider it an argument on par with the one that cigarettes are good for those with asthma.

  20. Canpharm says:

    I hate to do this b/c I love your blog but I just can’t agree with you. As you know, people are idiots and need to be protected from themselves. I know it sucks for the gov to make this decision and take away from your right to decide but it has to be done. Yes, gas stations etc. get to sell tobacco but they aren’t health professionals. As high-and-mighty as this might sound there is a higher professional standard pharmacists must adhere to.
    I hear you, it sucks when someone rams a policy down your throat whether you like it or not. In a perfect world gas stations etc. wouldn’t sell tobacoo either but at least maybe we can make a difference in our world and promote the “image” of pharmacists. I wish pharmacies could have made this decision themselves but sometimes we we go against out better judgement and let profits guide our way. Heck, we have to get what we can b/c are margins or so slim as it is but deep down it’s just the right thing do.
    Yes, it’s our right to be a hypocritical douches but we stuggle so hard to gain credibility in the medical field as it is. Selling tobacco only hurts our role as health professionals that swear an oath early in pharmacy school “to do no harm”. We are knowing “doing harm” when we as health professionals, choose to sell tobacco. If you choose to sell tobacco then every other pharmacy will choose to sell tobacco. Yes, the gov made the decision but I’m sure they were influenced by pharmacy colleges to some degree. The college, that represents pharmacists, helped bring this policy along. So in a way it wasn’t the sole decision of the government.
    I don’t think this is the birth of socialism in the U.S. and I’m pretty sure the gov who is influenced by pharmacy colleges aren’t going to pull birth control, plab B, sudafed, soda or candy any time soon. We have to be somewhat realistic here. However, you’re right sudafed, soda and candy do cause health problems, maybe they should be pulled as well? I guess I could argue that there is more evidence to support the detrimental health effects of tobacco smoke compared to sugar etc. It is a valid point you make however.
    It’s true, I’m sure it will hurt the profitability of pharmacies but we shouldn’t be in the business of delivering documented carcinogens to the public. At least we’ll have less break ins and less in store appearances from crack head junkies trying to buy smokes?
    I do like your idea of banning tobacco sales as a blanket policy everywhere as well. As you know, this would be impossible to implement. The pandora’s box of tobacco sales opened long ago and will unfortunately never be closed. Gov’s make a nice tax off tobacco sales and pushing the sale of tobacco products underground would only tax an already strained police force.

  21. http://openid.aol.com/stilts1007 says:

    Whether you think it is unprofessional (definitely) or morally wrong (probably) to sell tobacco at pharmacies, the fact is that is not something the government should be deciding for businesses. If public sentiment and/or corporate policy compelled pharmacies to stop selling tobacco, we pharmacists would, for the most part, be happy to comply.
    If I am not mistaken Walgreens stopped selling booze a few years back after some corporate bigwig’s kid got killed by a drunk driver. The policy change was met with a yawn, and WAG’s margins dropped a tick. Morally upstanding decision? Probably. Financially wise? No. But, WAG’s decision to make nonetheless.
    For those of you who are in favor of government banning tobacco sales in pharmacies or who think we as pharmacists are morally obligated to refuse to sell cigarettes to patients, fine. Next time you ring up a fat hypertensive diabetic’s meds and he plops down a 6-pack of Monster, a case of Funyuns, and a handful of Snicker’s, ask yourself if you are “doing the right thing” when you ring him up.

  22. ADHDCPht says:

    Canpharm, I hear you but I still disagree.
    I don’t believe we should protect people from themselves (with the exception of those that cannot help it, ie: the mentally ill) If a patient is purchasing Chantix along with a pack of Camels, then he is a retard by choice and deserves lung cancer/ a heart attack. I don’t understand society’s need to protect idiots like that.
    We blame the obese when they develop health problems due to their actions.
    We blame those who drive drunk and kill someone because of their actions.
    We do not except the excuses of parents who abuse their children and demand they be punished for their actions.
    However, if a smoker gets a terminal illness due to a lifetime of smoking, not only is it those bastard tobacco companies at fault, it’s also your local pharmacist’s fault for providing you an opportunity to buy it?
    What. The. Fuck.
    What I’m saying here is that such double standards are very reflective of the things society values. Even this ban mirrors that; pharmacies located within a larger “big box” store can sell ciggerates, but not in smaller, more – notice how I emphasize this- TRADITIONAL looking pharmacies. This ban, just like most any other, is all about appearances, and showing the people of SF that their lazy asshole city government is doing something good for them. Seriously, SF, with enacting this POS ordinance, is totally saying that if you’re an unkempt, uneducated, and poverty-stricken cashier at a shitty gas station somewhere you can sell ciggerates because that’s within *your* scope of business- but not for someone with a white coat that dispenses antibiotics and medical advice. You see, that looks BAD and such unseemly activities must be segregated. But it’s ok for you to sell tobacco and beer and candy and soda and fruit pies and maybe some asprin and ibuprofen to the public because……because…….?
    By the way, any policy not voted upon by the people’s representatives WAS the sole decision of the government, and that is not only wrong, but unconstitutional.
    I can’t imagine ever living in CA.

  23. neumeindil says:

    I think we’re all overlooking something here: most stores are already under this kind of control regarding alcohol, another ‘hot button’ drug that does more harm than good (mostly due to overuse). After Federal prohibition of alcohol failed so spectacularly in the 1920s, control of its distribution was given to the individual states; now, every state mandates what stores can and can’t sell alcohol, when and how they can sell it, and provides licensing and inspection for those retailers.
    In Ohio, where I grew up, one can buy beer and wine/liquor in any State licensed store that wishes to sell it. That means gas stations, Quick Marts, grocery stores, Walmart and liquor only stores all sell alcohol legally.
    In Pennsylvania, where I live now, ONLY state licensed stores may sell alcohol, but they may not sell other things. If I’m not mistaken, there are also different types of licensing for beers and liquor/spirits/wine, as evidenced by the liquor and spirits store 2 doors up from the grocery store-with-a-pharmacy where I work, and the beer only store 2 doors down from it.
    Cigarettes, I think, should be handled the same way; let the state authorities decide how cigarettes should be distributed and then put the issue on the May or November ballot so the voters can either agree or disagree. I think the aforementioned San Francisco law is poorly written and should probably be refocused, but at the same time, if that’s what the state of California thinks is urgent, it’s their job to address the matter. *sips her Jack n’ Coke*

  24. pitt says:

    I got another benefit to smoking aside from UC, it decreases the risk of N/V in ICU s/p surgeries. You could argue smoking helps decrease ICU stays, decreases costs by not having to have as much N/V prophylaxis, and reduces risks of complications by not having to take said meds. You can find a benefit to anything if you look hard enough. Fact is, this is government reaching further and further into everyday life and into the market, which for some reason I thought was a capitalist market controlled by supply and demand.

  25. Canpharm says:

    I’ve made my point in an earlier post so I don’t really want to waste your time and go into great detail again. Obviously, I am against the sale of tobacco in a pharmacy setting. I don’t mind the gov (who is influenced by pharmacy colleges who represent individual pharmacists and their views) to make the right deicison for pharmacies.
    Having said that, the legislation, at least in my neck of the woods, is useless. It’s useless because all a pharmacy has to do, is build a room with a separate entrance within the same pharmacy to sell tobacco. It’s ridiculous but the gov, ethical pharmacists, and pharmacy colleges can feel good about themselves because they are promoting health. Gov and pharmacies(if they choose) can continue to make money from the sale of tobacco. The smoker is happy because they can choose to continue slowly kill themselves and others around them through second hand smoke. There it is, no issue, no arguement, problem is solved. Right?
    Wait? What about the smoker that ends up in a hospital bed with lung cancer? He had enough money to buy tobacco but doesn’t have enough to pay his medical bills. What about his nonsmoking family member who ends up in an adjacent hospital bed as a result of second hand smoke? Who pays for these cases? This may not seem fair and I know you don’t want to hear this but you get to pay their medical expenses. You the tax payer, who has no “choice” in the matter, gets to pay for their medical expenses. I don’t expect Joe-Blow member of the public to grasp this idea but I do expect medical professionals to understand this issue.
    The pharmacy profession also suffers. How can we honestly call ourselves health professionals when we “choose” to sell tobacco to the laymen public? How can doc’s or the pubic respect a profession that “chooses” to sell tobacco? This gives them more justification to snub their noses at the pharmacy profession. It’s hard enough to gain their trust and respect as it is.
    I know profit margins are a motivation factor in supporting the idea of tobacco sales in a pharmacies. Even if you don’t own a store, tobacco sales help pay your salary as a staff pharmacist. Tell me this, if the gov paid you a monthly fee based on your current tobacco sales for not selling tobacco, would you still be so against the sale of tobacco in your store? If your answer is no, than the issue has been about money for you all along and deep down you could care less about your constitutional rights. If your answer is yes, then you should maybe think of another profession because pharmacy is an highly regulated profession. A profession that must adhere to certain gov standards and regulations and one that is subject to change from time to time.
    Awh, but like I said, if you want to sell tobacco build a separate room with an separate entrance it the pharmacy and all will be well with the universe again.

  26. steve intern says:

    I have two main points here:
    1. I also support the idea of pharmacies not selling tobacco products, because, as it has been pointed out several times, that just screams ‘hypocritical’ on our part as healthcare professionals.
    2. I am also against the state / government making decisions like this for businesses. The snowball effect is in motion; what’s next?
    So, solutions? Far as I can see, there are none. :-/
    To satisfy #2 above, take away the SF law restricting tobacco from being sold in pharmacies, and let the *business owners* decide what they want to sell. The problem with this is that damn near 100% of business owners would make the decision to sell tobacco products, because it is profitable. That would not satisfy #1 above. There’s that whole profit margin and economics bit coming into play again, much as it does with MTM services.
    As I understand it, there is no solution at this time that will satisfy both requirements I’ve come up with above.
    Let’s see how this pans out.

  27. Pharmacy Software Vendor says:

    Sure, smoking is bad for you, but so is Thalomid. If I look through all the side effects and complications from the 200,000+ drug products on the market, I assure you cigarettes wouldn’t be the worst.
    Pharmacists should be the last people on earth saying they won’t sell a product because it’s harmful.

  28. pharmacy meanie says:

    They banned tobacco in all stores “containing a pharmacy” in Ontario, Canada a few years back. All that did was the big stores now have a little enclave at the front that has it’s own entrance and thus is a separate store. So the little guy gets screwed. Personally, I think tobacco should be a “pharmacy ONLY” product. You should have to ask for it at the counter. And get a little lecture about how you should quit. And here are your options, patches etc. If the govt really wanted people to quit. which they don’t They want the tax money. Which is why 16 year olds running a cash at the local corner store can sell tobacco, but I with a university degree, cannot.

  29. red says:

    Pork rinds? Really?
    Yuk.
    I love how Americans throw around the word socialism at the slightest hint of government control. Sca-reee!
    Overall though, I agree, a ban is heavy handed. It would be great if pharmacies and others would voluntarily stop selling them, but they’re a cash cow. Let the assholes smoke themselves to death I guess. Wish I could prevent the stupid kids from starting, and I try to get people to quit daily.

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