San Francisco and Berkeley miss opportunity to help smokers quit

San Francisco and Berkeley missed an opportunity to help smokers quit when the cities moved all tobacco sales out of pharmacies, according to a new Bay Area health initiative. Instead of having smokers buy cigarettes in convenience stores and at other retailers, smokers should buy cigarettes only at pharmacy counters, says Stuart Skorman, founder of Elephant Pharmacy.

Launching HealthyPharmacies.org, Skorman is focused on making pharmacies centers of health and wellness at the community level. "They can't just sell medicines to people who are sick. They must educate consumers and give them tools to lead healthier lives."

Keeping cigarettes behind the pharmacy counter would do just that, Skorman says. When a smoker asks for a pack of cigarettes, pharmacy staff would have the opening to offer nicotine replacement, such as the patch or gum, or point smokers in the direction of counseling and other tools. The approach wouldn't require a prescription for tobacco but would offer smokers tools to help them quit.

In California alone, more than four million people smoke - more than the entire population of Oregon. About 90 percent of smokers start before age 18 and become addicted to nicotine. That addiction makes it tough to quit: more than 70 percent of smokers want to quit but don't know how to do it.

Pharmacies are the only stores that are licensed to sell dangerous drugs, and Skorman says tobacco must be treated as such. He believes that tighter controls would not only create access to quit-smoking support but could reduce the powerful point-of-purchase advertising that appeals to youth in convenience stores and other retail locations.

Calling this approach a public health and economic win, Skorman sees great potential for pharmacies to play a powerful role at the community level.

"We're primarily focused on reducing tobacco use, but this approach would bring more people into pharmacies, too. That's good for business, and it's good for the consumers, if they're receiving positive guidance to live healthier lives," he said.

HealthyPharmacies.org plans to pilot this concept by working with several cities to limit tobacco sales to only pharmacy counters and then measure the results - including changes in tobacco sales and smoking rates. Skorman is reaching out to public health advocates and pharmacies to partner in this effort and is exploring pilot projects in more than 50 US cities.

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