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Roy Guharoy, PharmD, MBA, FCCP; John Noviasky, PharmD, BCPS; Ziad Haydar, MD, MBA; Mohamad G. Fakih, MD, MPH; Christian Hartman, PharmD, MBA
Author and Funding Information

From Ascension Health (Drs Guharoy and Haydar); University of Massachusetts Medical School (Drs Guharoy and Hartman), Worcester, MA; SUNY-Upstate Medical University Hospital at Community General (Dr Noviasky); St. John Hospital and Medical Center (Dr Fakih); and Wayne State University School of Medicine (Dr Fakih).

Correspondence to: Roy Guharoy, PharmD, MBA, FCCP, Ascension Health, 11775 Borman Dr, Ste 340, St. Louis, MO 63146; e-mail: Roy.Guharoy1@umassmed.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(2):717-718. doi:10.1378/chest.13-1116
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To the Editor:

We thank Dr Jha for his feedback on our commentary.1 Although not directly related to the topic of our article, protecting patients from harm represents a common theme. We agree that tobacco sales in retail pharmacies are contradictory to the pharmacists’ role as patient care providers. It is hypocritical for a pharmacy where pharmacists provide counseling for medication adherence, smoking cessation, and vaccinations to also engage in selling tobacco products.

Although national tobacco sales decreased by 17.43% between 2005 and 2009, US pharmacies increased their sales by 22.7% during the same period.2 Pharmacies account for almost 5% of total cigarette sales in the country. Independently owned pharmacies are less likely to sell tobacco products than retail chain pharmacies.2 The majority of professional organizations, including the American Society of Health System Pharmacists with a 36,000-plus membership, strongly opposes the sale or distribution of tobacco products in all establishments where health-care services are rendered.3 Despite the overwhelming professional opposition, the sale of tobacco products by chain pharmacies and grocery markets that contain pharmacies continues to increase.

Tobacco use is a major leading preventable cause of chronic illness and death in the United States. It is responsible for one in five deaths annually in the United States and increases health-care spending by $193 billion annually.4

The Institute of Medicine recommended in 1994 to ban tobacco sales in US pharmacies as part of a comprehensive strategy to reduce tobacco use among young people.5 However, with the exception of a few cities, pharmacies and health-care facilities are not legally prohibited from selling tobacco products.2 All the stakeholders involved in health-care delivery and the advocates of patient safety need to collaborate to ban tobacco sales in pharmacies across the country. The moral incentive of first do no harm to the patients should arise as a priority before the financial incentive. With the majority of pharmacists not supporting tobacco sales in pharmacies, the right time to act is now.

References

Guharoy R, Noviasky J, Haydar Z, Fakih MG, Hartman C. Compounding pharmacy conundrum: “we cannot live without them but we cannot live with them” according to the present paradigm. Chest. 2013;143(4):896-900.
 
Seidenberg AB, Behm I, Rees VW, Connolly GN. Cigarette sales in pharmacies in the USA (2005-2009). Tob Control. 2012;21(5):509-510. [CrossRef]
 
ASHP therapeutic statement on the cessation of tobacco use. Am J Health Syst Pharm. 2009;66(3):291-307. [CrossRef]
 
Garrett BE, Dube SR, Trosclair A, Caraballo RS, Pechacek TF; Centers for Disease Control and Prevention (CDC). Cigarette smoking-United States, 1965-2008. MMWR Surveill Summ. 2011;60(suppl):109-113.
 
Lynch BS, Bonnie RJ., eds; Committee on Preventing Nicotine Addiction in Children and Youths, Institute of Medicine. Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youths. Washington, DC: National Academy Press; 1994.
 

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References

Guharoy R, Noviasky J, Haydar Z, Fakih MG, Hartman C. Compounding pharmacy conundrum: “we cannot live without them but we cannot live with them” according to the present paradigm. Chest. 2013;143(4):896-900.
 
Seidenberg AB, Behm I, Rees VW, Connolly GN. Cigarette sales in pharmacies in the USA (2005-2009). Tob Control. 2012;21(5):509-510. [CrossRef]
 
ASHP therapeutic statement on the cessation of tobacco use. Am J Health Syst Pharm. 2009;66(3):291-307. [CrossRef]
 
Garrett BE, Dube SR, Trosclair A, Caraballo RS, Pechacek TF; Centers for Disease Control and Prevention (CDC). Cigarette smoking-United States, 1965-2008. MMWR Surveill Summ. 2011;60(suppl):109-113.
 
Lynch BS, Bonnie RJ., eds; Committee on Preventing Nicotine Addiction in Children and Youths, Institute of Medicine. Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youths. Washington, DC: National Academy Press; 1994.
 
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