US pharmacies sell cigarettes for less than other stores

Shelves full of cigarettes are pictured at a CVS store in the Manhattan borough of New York February 5, 2014 (REUTERS/Carlo Allegri/File Photo)

Cigarettes are often cheaper at the very place that people shop for health supplies and fill medicine prescriptions, according to a new study in California.

"Compared to other types of stores, pharmacies charged customers less for cigarettes, more for bottled water," said lead author Lisa Henriksen of the Stanford Prevention Research Center at Stanford University School of Medicine in Palo Alto.

"It's surprising that stores that are supposed to promote health sell the world's deadliest product of all, and even worse that they sell it at the cheapest price," Henriksen said.

Pharmacies represent 7 percent of the 380,000 tobacco retailers nationwide, Henriksen and her colleagues write in the American Journal of Public Health.

Convenience stores sell many more cigarettes, but pharmacies offer them at cheaper prices, she told Reuters Health.

"Price is the single best predictor of use, with lower cigarette prices driving higher smoking rates, lower quitting rates, and higher rates of smoking initiation among teens," she said. "The most vulnerable population groups are also the most price sensitive, which is why the findings about neighborhood disparities in prices are also important."

Researchers found that among pharmacies, Newport menthol cigarettes, popular among African Americans, were among the cheapest brands, and they cost even less at stores in neighborhoods with a higher proportion of black residents.

The researchers randomly selected more than 500 licensed tobacco retailers in California in 2014 and recorded the prices of their Marlboro cigarettes, Newport cigarettes and the cheapest cigarettes available as well as the price of bottled water.

They gathered similar data from more than 2,000 retailers across the U.S. near schools with eighth, tenth and twelfth graders in 2012.

In both studies, the least expensive cigarettes per store were cheaper in pharmacies - by $0.47 to $1.19, on average, in California. Bottled water, which may reflect the pricing of a range of other goods, cost more in pharmacies than in other stores, like convenience stores.

While bottled water prices did not vary by neighborhood demographics, the cost of Newport and other cigarettes varied by race or neighborhood income and age profiles.

Amanda Amos, professor of health promotion at the University of Edinburgh in Scotland, told Reuters Health by email that she was "shocked and bemused" to learn pharmacies in the U.S. would sell cigarettes, which are the most lethal legal product on the market and kill half of all regular users.

"Pharmacies (in the U.K.) would never sell cigarettes as this does not fit in with their health promoting role," said Amos, who was not part of the new study. "Rather, most pharmacies would see their role as helping smokers to quit through providing nicotine replacement products and support."

Amos worked on two reviews for the European Commission that found increasing the real price of cigarettes was the most effective way to reduce smoking uptake in young people and increase adult quitting, she said.

Laws prohibiting tobacco sales in pharmacies are rare in the U.S., despite wide public support in polls. San Francisco passed the first law and 70 percent of Massachusetts residents live in jurisdictions with tobacco-free pharmacies, http://bit.ly/2bRQhqM told Reuters Health.

"Apart from whether it decreases smoking, it has the added advantage of denormalizing tobacco and reducing its availability," she said. "There are many more tobacco retailers than needed to meet demand for the product."

For jurisdictions looking to reduce the number of tobacco retailers, pharmacies are an obvious choice, she said. "Tobacco-free pharmacies are low hanging fruit for state and local tobacco control."