US Pharm. 2006;8:1

The controversy of what a "typical" drugstore should sell has gone on for ages, probably as long as the practice of pharmacy itself. The pictures we see in the history books of the first drugstores generally depict small apothecary shops with pharmacists diligently compounding behind a prescription counter, with bottles of chemicals as its backdrop. While the pharmacy department was obviously the focus of these stores, if you look carefully, you can see the over-the-counter "wet" and "dry" products in the front section of the store: products like boric acid, Epsom salts, Mercurochrome, and hydrogen peroxide.

In later years, the ubiquitous soda fountain appeared within drugstores. Many said that a drugstore was no place for ice cream sodas and egg creams. But the soda fountain flourished as a drugstore fixture for many years, until retailers decided that greeting cards and other merchandise would return a better profit. With the proliferation of chains over the past century also came an increase in the kinds of merchandise carried in front of the prescription counter, and the controversy over whether a drugstore should carry motor oil and power tools ensued.

A news story out of New York recently got my attention. While it doesn't relate to drugstores exclusively, it certainly has a strong relationship. You see, according to New York City's health commissioner, the city is thinking about passing a law that would raise the smoking age from 18 to 21. Obviously, this would make it illegal for anyone younger than 21 to buy cigarettes. New York already has a citywide smoking ban in bars and restaurants. This kind of legislation has no middle ground. If you are a smoker, you are against it; conversely, nonsmokers applaud it.

Any number of studies show that smoking and secondhand smoke are a health risk. Unless you've been living on a deserted island for the past 40 years, you know that cigarettes in this country carry on every pack of cigarettes the surgeon general's warning about the health hazards of smoking; and since 1969, cigarette advertising on television and radio has been banned. The Centers for Disease Control and Prevention (CDC) estimates that 25 million people will die prematurely from smoking-related illnesses; this includes an estimated five million who are now children and adolescents younger than 18. As though that were not enough, the CDC estimates that about 10 million people have already died from smoking-related diseases in the United States.

This has left many of today's drugstores with a big dilemma. While some may continue to argue that retail drugstores shouldn't sell hardware or automotive supplies, it is tough to make that argument on the basis of promoting good health. Regardless of what it sells in front of the prescription counter, a drugstore's pharmacy department is still the epicenter of health care for millions of Americans who depend on pharmacists to dispense lifesaving drugs. So the real question is: Why would any establishment that is portrayed as a health care oasis for so many people sell a product that has a proven track record of causing illness? Not only is smoking a confirmed health hazard, it is diametrically opposed to the message that pharmacy tries to send out to patients every day. Anything that is obviously deleterious to one's health should not be sold in a drugstore; and to my way of thinking, at the very top of that list are cigarettes and other related tobacco products.

Harold E. Cohen, R. Ph.
Editor-in-Chief

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