Public Health | Health Commentary

Tobacco Sales at Pharmacies?

Mon, 06 Oct 2008 23:40:55 -0400

An odd combination, but retailers are in it for the moneyA new bill pending in Congress would give much greater government oversight of tobacco and new bold graphic warnings on cigarette packages. That’s great news – if it passes. But while cigarette packaging may look different, tobacco will likely be sold in familiar aisles. And that's where you might find a surprise. Where are cigarettes sold in America? About two thirds, as one would expect, are sold in convenience stores, 11% in grocery stores or supermarkets, 11% in tobacco outlets, and 3% in liquor stores. The surprise is that nearly 4% of total tobacco sales are from pharmacies.

That’s right – some of the places that are supposed to be protecting your health are also selling cigarettes. The juxtaposition of cigarettes and pharmaceuticals (including some to address nicotine addiction) is an odd one indeed. In fact, a survey of 1,000 California pharmacists found that 82% support a ban on cigarette sales in pharmacies. Unfortunately, they don't have final say in the matter.

A similar conflict exists in big-box retailers like Wal-Mart, which are the home not only of pharmacies but over 1,000 in-store health clinics across the United States.

Why do they do it? One word - money! In 2007, over 17 billion packs of cigarettes were sold in this country. Grocery stores, drugstores, wholesale clubs and mass merchandisers were responsible for $13 billion in sales, nearly 20% of the total buy. With that kind of money, it's not surprising that Wal-Mart hasn't budged. They're not taking questions on the issue these days. But in the past CEO Lee Scott has said, "There are still a tremendous number of our customers who smoke. We've got a market to serve, and second we have shareholders to think about." The National Association of Chain Drug Stores is also taking a hard line.

Others have broken ranks. Target quit selling tobacco products way back in 1996, and CVS has hinted that it is headed in the same direction. And states and municipalities across the United States this year have been writing legislation that would disintegrate the sale of tobacco from outlets that provide health services and medication.

These retailers are smart to bite the bullet now. As tobacco remains under attack by health advocates, revenues from sales will likely decline while the adverse impacts on corporate health images and their defining brands will only continue to grow.

For more information about this topic, please watch the video, embedded with this blog post, or read the full transcript, below. Then send a comment. Should we be pressuring drug stores more forcefully to give up their tobacco sales?

Of Candidates and Tanning

Wed, 17 Sep 2008 11:27:17 -0400

Why buying a tanning booth for the Alaskan governor's mansion is a bad idea

This week we learned that VP candidate Sarah Palin had installed a tanning booth in the Governor's Mansion in Alaska. When the news broke, the first to react were the Tanning Booth Association advocates. Smart Tan Vice President Joseph Levy said: “People need to remember that indoor tanning was invented in Europe in light-deprived Northern European countries as a therapeutic exercise. It should not be a surprise to anyone that an Alaskan turns to indoor tanning.” Not shying away from the obvious juxtaposition with presidential candidate John McCain's challenge with melanoma, Levy continues: “McCain’s condition — attributed to years of sunburn on his type I skin as a prisoner of war in Vietnam — and Palin’s tanning bed should allow the tanning community the opportunity to tell our story correctly,” Levy said.

What are the real facts when it comes to tanning beds and health?

The truth is that we live in a culture that still places a high premium on youth, good looks and glamour. And nothing says “glamorous” more than a deep tan, or so it seems. That’s why you may have noticed a surge in tanning booths in your local community.

Tanning is big business. And young people, in particular, are plunking their money down and climbing into the booths – even though many of them realize there is a health danger associated with tanning.

Consider just how fast the tanning salon business is growing. In the United States, there are 25,000 plus tanning outlets, with 160,000 employees serving some 30 million customers. At $20 to $50 dollars per session, with beauty add-ons, that represents more than $2 billion in spending per year. All of this growth comes at a time when skin cancer rates have also soared.

The American Medical Association, the American Cancer Society, the World Health Organization and a host of others say exposure to ultraviolet rays from the sun or from tanning booths is the primary culprit for today’s skin cancer rates. Studies reveal that the rays, including ultraviolet A, which damages not only the surface epidermis but the connective tissues and vessels below, and ultraviolet B, which is prone to quick surface burns, may cause cancer.

The link between ultraviolet rays and cancer doesn’t seem to concern the tanning booth industry’s lobbying group, The Indoor Tanning Association. They embrace it and run with it, saying the experience is “more than just a good tan; [customers] also enjoy the positive psychological and physiological effects of regular exposure to ultraviolet light.” They claim that moderate tanning has never been linked to skin cancer and that tanning booths are effective for activating vitamin D and building strong bones. But the reality is that we get plenty of vitamin D from normal sources. The World Health Organization says that 5 to 15 minutes of casual sun exposure of the hands, face and arms, 2 to 3 times a week during summer months, is sufficient to keep vitamin D levels high.

So here we are, in the 21st century, unwilling or unable to regulate an industry whose profits come only with rising disease burdens and health costs for the nation.

The AMA has called for three simple and reasonable steps to bring about change. Number one, tanning booths should be off-limits to those 18 or younger. Number two, the FDA should conduct hearings to weigh-in on risk and the need for increased regulation. And number three, booths should come with a Surgeon General’s warning.

Responsible legislators have advanced bills, and Congress should approve these. As sponsor Carolyn B. Maloney, a Democratic congresswoman from New York says, “New cigarette packs say smoking causes cancer. We don’t want to wait another 50 years to have labels that adequately warn people that tanning beds cause cancer.”

I agree, and hope all four candidates for president and vice-president will reject tanning booths as a “healthy option.” As always – to learn more, watch a special video embedded with this blog post (this week it’s from our Health Politics archive) or read the full transcript to learn more. Then send a comment expressing your feelings about tanning booths. Do you think they are safe?

Change in Policy at FDA May Result in Improved Drug Safety

Tue, 09 Sep 2008 17:54:39 -0400

On June 30, 2008, the Food and Drug Administration (FDA) shifted authority on drug safety regulatory issues from the Office of New Drugs (OND) to a shared responsibility between OND and the Office of Surveillance and Epidemiology (OSE). Under the new policy, the drug review and drug safety offices will share equal responsibility on “significant safety issues” for pending and approved products, such as post-marketing studies and clinical trials, and safety labeling changes. Joint authority between OND and OSE was recommended in the Institute of Medicine report The Future of Drug Safety: Promoting and Protecting the Health of the Public, released in September 2006.

Prior to this change, OSE was responsible for identifying drug safety concerns and possible corrective measures to improve product safety and protect the public health, yet only OND had the authority to recommend that these products be withdrawn from the market. Now, OSE will have a formal role in drug regulation and can work with OND to take action regarding postmarketing safety. When the IOM released The Future of Drug Safety, its authors believed joint authority would help break down cultural barriers as both staffs work toward the common goal of evaluating and ensuring drug safety and efficacy over a product’s lifecycle.

In the current environment, in which the brand names of drugs are well-known and pharmaceutical companies advertise during prime time TV, consumers are making choices about their medications that they previously delegated to their doctors. They have come to rely on the FDA for its recommendations as they weigh the benefits against the risks. Well-publicized cases, such as Merck’s removal of the arthritis and pain-relief drug rofecoxib (Vioxx®) from the market when concerns were raised about its health risks, can result in consumer confusion by the conflicting information available to them.

While direct impact from this change in authority may be hard for the general public to see, these changes within FDA may result in improved surveillance and ultimately improved drug safety. Under the new policy, the two offices will take a more active and coordinated approach to monitoring products for adverse effects during postmarketing, which will help identify problems at an earlier stage. The collaboration also will provide for a more informed discussion among policymakers when considering whether to request a medication be withdrawn from the market.

Public Health | Health Commentary

Tobacco Sales at Pharmacies?

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Of Candidates and Tanning

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Change in Policy at FDA May Result in Improved Drug Safety