Respectful Insolence

CVS, tobacco, and knee jerk reflexes

Now we come to a post in which Orac unloads a bit about one of his pet peeves. It is a post that will likely piss a few people off on “his” side. If it does, so be it. He does this now because yesterday something happened that irritated the crap out of me because it put on display one of the less appealing characteristics of the skeptical movement, a tendency to obsessively focus on what it views as important at the expense of losing touch with the big picture. It is a story about knee jerk responses to which we all (myself included) fall prey.

Yesterday it was widely reported in the media, arguably the biggest story of the day other than the havoc snowstorms were causing across huge swaths of the country, that the second largest pharmacy chain in the United States, CVS Caremark, is going to stop selling tobacco products in its 7,600 stores:

CVS Caremark Corp said on Wednesday that it would stop selling tobacco products at its 7,600 stores by October, becoming the first U.S. drugstore chain to take cigarettes off the shelf.

Public health experts called the decision by the No. 2 U.S. drugstore chain a precedent-setting step that could pressure other stores to follow suit.

CVS, whose Caremark unit is a major pharmacy benefits manager for corporations and the government Medicare program, believes the decision will strengthen its position as a healthcare provider.

“I think it will put pressure on other retailers who want to be in healthcare,” said CVS Caremark Chief Medical Officer Dr. Troyen Brennan.


Make no mistake about it, this is a rare instance of a corporation doing the right thing. I’m under no illusion that CVS expects that this decision will in the long run help its bottom line, there is no doubt that in the short term the company will lose a lot of money. News reports that I saw last night estimated that CVS will be giving up $2 billion a year in sales, $1.5 billion in direct tobacco product sales and around $500 million spent by smokers on other products because they happen to be in the store to purchase their nicotine fix. While it’s true that in the US the days of the old-fashioned pharmacy are long over and these days many pharmacies seem more like convenience stores with a pharmacy attached than a pharmacy (heck, there was a rather amusing parody commercial for CVS as the place to go to get Valentine’s Day gifts on the most recent episode of Saturday Night Live), pharmacies are still health care businesses. Given the massive toll on public health that smoking takes and the number of preventable deaths caused by the use of tobacco products, the move by CVS is huge and is to be praised. At least, that’s what I think, and I posted as much on my Facebook page, along with a link to the story above, saying that as a pharmacy chain CVS is in the healthcare business and shouldn’t be selling something as harmful to health as tobacco.

What do you think was the first comment after that?

Yes, it was a link to this, the part of the CVS website that covers homeopathic remedies. Everywhere I went (at least in the usual skeptical hangouts, which is where I tend to be in the blogosphere and Twitterverse), that’s all I saw, almost always the first reaction to the CVS story was to say something along the lines of, “Well, yeah, that’s great, but what about homeopathy?” It’s a misguided and, frankly, annoying reaction.

At that point, I got annoyed and pointed out that it irritates the crap out of me that the first reaction of skeptics to this news is not to praise CVS for making a bold move that will hurt its bottom line in the name of living up to at least one of its responsibilities as a health care provider, but rather to criticize it for still selling homeopathy. As I pointed out, there’s time for that later. As a physician, I see getting rid of tobacco products as a much bigger deal. In terms of the toll on health, compared to the horrific effects of tobacco products, the effect of CVS selling homeopathic products is, well, homeopathic. Most homeopathic products are harmless; the manufacturers, knowingly or unknowingly, scam the purchaser by selling something that does nothing. Tobacco products, on the other hand, are addictive and actively contribute to death through their ability to increase the risk of heart disease, various cancers, chronic lung disease, and other conditions. Even accounting for the occasional homeopathic product that has something harmful in it, there’s no comparison. Tobacco wins, hands down by a landslide, in the contest for which product causes more harm.

One of my Facebook friends put it perfectly; so I’m going to shamelessly steal his analogy. What we as skeptics are doing is to praise the company, but then immediately add a “but…” which is likely to be counterproductive. Consider this example. Your friend has just successfully quit smoking (example intentional) and tells you he’s reached his one year mark off of cigarettes. In response, you say, “That’s great! Good work. Now, about your weight…” In the same way, skeptics are saying things like, “Great job, CVS. Excellent decision. Now, about that homeopathy…” Do you think the company is likely to react favorably to this? More likely, the reaction would be to think, “No matter what we do, it’s never enough with you people, is it?”

We see this self-righteous scolding tendency on full display in a post on Skepchick by Heina Dadabhoy that declares the whole decision to be a “smokescreen” and a “publicity stunt,” based on what she “knows as a former CVS employee.” One of her arguments is that CVS sells quack remedies. (Yes, yes, we know. So does every other pharmacy chain.) The others are mostly non sequiturs, such as the assertion that CVS participates in food desert situations based on her personal experience. She also then brings up what she sees as exploitative labor practices and this:

The numbers don’t lie. CEO pay is rising while worker pay and benefits are falling. What used to be jobs by which teenagers could earn extra cash (retail, fast food, and so on) now constitute many adults’ main source of income. Remember my coworkers who worked multiple jobs? There are very few full-time positions available in retail; most retail positions these days are “part-time” (read: 35-hour-a-week) jobs designed to ensure that people aren’t eligible for benefits. As a result, people with dependents are forced to work two or three jobs in order to make ends meet. This means juggling transportation as well as multiple schedules and uniforms, ensuring more difficulties for people whose lives are already difficult.

I get it. Food deserts are bad. If you want to see a whole city that is, except for a couple of small areas, a food desert, come to Detroit, my hometown. It’s so bad here that it was a huge deal when Whole Foods opened a store in Midtown last summer, and to my knowledge there still aren’t any stores from major chains within the city limits. However, all of this, as unfortunate as it is, has nothing to do with whether or not the decision to drop tobacco products was a rare responsible decision by a large corporation. Who knows? It might be the harbinger of things to come in the industry, putting pressure on other pharmacy chains to stop selling cigarettes as well, although it might take time. Walgreen’s response to the decision by CVS, if I’m to judge by the disingenuous corporatespeak Walgreens issued about its sale of cigarettes and other tobacco products in its stores.

Yes, I know that the argument is that CVS doesn’t care about the health of its workers. No, no one’s claiming that CVS is a paragon of corporate virtue. Yes, CVS stores in states that allow it even still sell booze. Of course, although booze can cause serious health problems in those who become dependent on it, it can also be enjoyed responsibly in moderation. At “low doses,” wine, for instance, can even be healthy. In contrast, smoking cigarettes is never healthy or even neutral. The same argument applies to the other favorite argument, enshrined in the Skepchick post, namely that the convenience store part of CVS still sells snacks, candy, pop (I’m from Michigan), and other foods and drinks that aren’t particularly healthy. These things can be enjoyed in moderation in a manner consistent with health. Not so, cigarettes.

Finally, one reader characterized my argument as being that skeptics should avert our eyes and be silent on issues that we’ve been fighting for years. Nothing could be further from the truth. My point was that when a company does something that is good for public health (or at least makes a strong statement consistent with public health), potentially at significant expense to its bottom line, even if that expense is likely to be short term and the company expects long term benefit, our first response as skeptics shouldn’t be to immediately attack the company for not doing something else that we think it should be doing. Accept the good action for what it is, acknowledge that it’s good, and resist the impulse to instantly yoke it to criticism of bad things the company is still doing. Save those complaints for another time, long enough to decouple the deserved praise for the good action from the pressure for more action on the first comment.

Don’t be that scold in the example above congratulating someone for quitting smoking but then telling him in the same breath it’s time to lose weight. (Oh, and what about his horrible wardrobe and hair that desperately need a makeover?) To do so is counterproductive and makes us look like zealots who are so wedded to our causes that we can’t see the big picture. None of this is to say that we shouldn’t resume the pressure on pharmacies to stop selling homeopathic remedies next to real medicine, but keep this in mind. Even if CVS were to stop selling homeopathic remedies tomorrow, the impact on public health (and the company’s bottom line) would be minuscule compared to that of ceasing to sell cigarettes and tobacco products. That’s not to say that getting homeopathic remedies out of pharmacies isn’t important, but its importance is dwarfed by the horrific toll on public health due to tobacco products.

Comments

  1. #1 The Smith of Lie
    February 6, 2014

    Walgreen’s response to the decision by CVS, if I’m to judge by the disingenuous corporatespeak Walgreens issued

    It seems like the part of sentence got cut when posting.

  2. #2 palindrom
    February 6, 2014

    Hear, hear.

    I’m married to an actual sane person, who reminds me on occasion that the self-righteousness of the skeptical movement can be supremely off-putting to most people. This appears to be a perfect example.

  3. #3 Gingerbaker
    Burlington, VT
    February 6, 2014

    Wouldn’t it be a better world if Mom & Pop corner stores voluntarily stopped selling beer? Beer should have pictures of a cirrhotic liver on their labels.

    Yeah, let’s applaud CVS for refusing to sell legal substances to people who are physically addicted to them! Huzzah!

    Smoking is bad for your health, and those of us who control supply shouldn’t allow people to buy things that we all agree are bad for them and we should do it out of principle, right? This is all about ethics, harm, and risk.

    Que McDonalds, every grocery that sells bacon, pistol manufacturers, sports car dealerships. Goodbye bungee cord jumping, snow boards. God, it’s going to be great!

    But, remember, never ever ever use a science blog to talk about frog marching the Koch brothers to the Hague for crimes against humanity or the ethics of blowing up the Keystone pipeline. That might be construed as unseemly.

  4. #4 Andrey Pavlov
    February 6, 2014

    I absolutely agree with you Orac. We need to provide positive reinforcement for good decisions, not just keep complaining that things aren’t good enough for us.

    We’re skeptics for chrissake! It will never be good enough! And it shouldn’t! That’s the point – no matter how good things are they can always be better. But if we just focus on the next thing that needs to be better without pausing to acknowledge good work done, then we’re either nihilists or assholes (and probably both).

  5. #5 Durango
    February 6, 2014

    I saw that Skepchick article and it irritated the hell out of me. So CVS isn’t perfect. One step in the right direction is good, I’ll take it.

  6. #6 Marry Me, Mindy
    February 6, 2014

    My response was, jeez, they just now got around to stop selling something that directly causes harm. And suddenly you expect them to quit selling something that just doesn’t do any good?

    I don’t disagree that it would be great to get CVS and others to stop selling homeocrap. But let’s recognize a good thing when we see it – and what CVS has done here is good.

    That doesn’t make anything else they’ve ever done good, but we shouldn’t dismiss it.

    This reminds me of how the gay community reacted to Obama’s first year in office. I listen to gay satellite radio a lot, and there were a ton of complaints that he hadn’t done enough. People were all giving him an “F” for his handling of gay issues.

    Now, it’s true that he hadn’t made any big pronouncements yet at that point, or made any policy changes, BUT he also had made a lot of supportive comments, or especially not anti-gay comments. I was thinking, if Obama got an F, what grade would you actually give a person who had actively worked against you?

    Of course, the first steps are, pretty much by definition, not enough. If they were enough, they wouldn’t be the “first steps.”

    Let’s applaud the fact they have taken a step in the right direction, and encourage them to take more.

  7. #7 Denice Walter
    February 6, 2014

    It’s a COMPANY- it has to make a profit- this action will cost it a great deal of money that it will hopefully recoup because of good press. I think that it’s a laudible move. Don’t expect miracles from chain stores.

    HOWEVER because this action is health-oriented, I wonder if whatever they will now sell in order to replace the profit lost will also focus on ‘health’ or cater to that audience.

    Maybe more supplements or herbal remedies? Exercise equipment? Organic fruit?
    Or perhaps more useless, overly-priced trendy items for people to waste money on? Or candy.

  8. #8 Mephistopheles O'Brien
    February 6, 2014

    This tendency is, unfortunately, not confined to the skeptical movement. Some years ago when Dr. George Tiller was murdered there were a number of messages that went out from people saying, “murder is wrong, but he shouldn’t have been performing abortions”.

    In this case it is far better to split the messages out into separate posts. Yes, we applaud CVS’s decision not to sell tobacco (assuming we do). Give it a day before saying, “so, how about them homeopathy remedies, huh?” or “so why are you still selling beer there, eh?”.

    Personally, I neither support nor denounce CVS’s decision but it was their decision.

  9. #9 Adam
    February 6, 2014

    CVS and Walgreens have become more like convenience stores that happen to sell drugs (and lots and lots of woo) rather than pharmacies. While it’s good that CVS is changing its image a bit, I can’t help but feel that the word “pharmacy” should be a protected term and it should come with rules about what products that can be sold within 5m of the counter or over the counter medicines.

  10. #10 Composer99
    February 6, 2014

    I have a hard time imagining that this:

    News reports that I saw last night estimated that CVS will be giving up $2 billion a year in sales, $1.5 billion in direct tobacco product sales and around $500 million spent by smokers on other products because they happen to be in the store to purchase their nicotine fix.

    squares with this:

    Heina Dadabhoy that declares the whole decision to be a “smokescreen” and a “publicity stunt,”

    Giving up sales to the tune of billions of dollars a year strikes me as much, much more than a publicity stunt.

  11. #11 Mu
    February 6, 2014

    The day they also stop selling booze, high sugar drinks and high fat snacks I start thinking they might do it for actual health reasons. This is just a marketing gimmick where someone figured out that the loss of sales is made up by the “positive” publicity.

  12. #12 Lyle
    February 6, 2014

    Re #9 Recall that CVS is working on building more instore clinics. They are building more minute clinics. Since they want to be see as a health care provider and not just a convenience store, not selling tobacco makes a lot of sense, since they do want folks to use their minute clinics for urgent care cases.

  13. #13 Denice Walter
    February 6, 2014

    A quick look at CVS Caremark Corp stock prices( @ marketwatch.com) shows that over the past 5 years** the company has done very well: they entered 2014 with high prices.
    The tale of the tape this week and next might illustrate what investors think about their decision.

    ** those earlier low prices might be recession related (2009).

  14. #14 Orac
    February 6, 2014

    I saw that Skepchick article and it irritated the hell out of me. So CVS isn’t perfect. One step in the right direction is good, I’ll take it.

    Yeah, it’s a horrible article that goes beyond yoking homeopathy to this decision to yoking all sorts of political issues for no good reason that I could discern other than that she wanted to. I could have spent a whole post fisking it line by line, but I resisted the temptation.

  15. #15 Orac
    February 6, 2014

    Since they want to be see as a health care provider and not just a convenience store, not selling tobacco makes a lot of sense, since they do want folks to use their minute clinics for urgent care cases.

    Exactly. And if that strategy works out, it might well be that down the line CVS will stop selling booze and at least the most unhealthy of the unhealthy food. One step at a time. And if it doesn’t, nothing says to withhold fire. Just try to reward CVS now for a good decision, give it a little time, and then go back to these issues.

  16. #16 Anne Jordan-Baker
    February 6, 2014

    I think this is a big deal. I heard a news report on this the other day in which the reporter chastised CVS for continuing to sell junk food and candy. My 11-year-old was in the car with me, and I practically started screaming at the radio, “No!” CVS may do other things that are wrong or not perfect, but this decision is nothing but good. We get our prescriptions filled at CVS, and it will be nice to go in there and see the cigarettes gone. When my daughter goes in there by herself (which she likes to do after school sometimes on her way home), she won’t see cigarettes. She’ll still see candy and all manner of junk food, but that is way less dangerous to her than smoking and the implicit approval stores provide by selling tobacco. I personally applaud CVS for this move and think other stores such as Walgreen’s will now feel the pressure to do the same. CVS stores are so ubiquitous that this sends a great big message, imo. I am nothing but happy about it.

    Thanks for reading my rant. I realize you don’t know me at all, but this thing really bugged me.

  17. #17 Orac
    February 6, 2014

    But, remember, never ever ever use a science blog to talk about frog marching the Koch brothers to the Hague for crimes against humanity or the ethics of blowing up the Keystone pipeline. That might be construed as unseemly.

    What on earth are you talking about? You make no sense at all.

  18. #18 Gregor Samsa
    Durham, NC
    February 6, 2014

    The CVS website’s treatment of homeopathy (http://health.cvs.com/GetContent.aspx?token=f75979d3-9c7c-4b16-af56-3e122a3f19e3&chunkiid=38314) does not seem to offer all that much support for it. It likens it to perpetual motion machines, ghosts, and ESP. You would have to have a heart of stone not to laugh at the description of homeopathic dilution. The site may be worth a bookmark for its description of scores of homeopathic “remedies” and its comments about them.

  19. #19 Irène Delse
    February 6, 2014

    Hmmm. I don’t know, Orac. “Don’t be a scold” is good advice if we are engaging with a friend who’s making their first steps towards taking better care of themselves, but corporations are not people. Also, more importantly, towards the end of her post, Heina addresses the link between poverty and tobacco addiction. The management practices she saw don’t seem to be exceptionally extreme: after all they are the same as what Wal-Mart, McDonald’s and others do. So why dismiss what she says about the debilitating effects of that kind of work environment. I agree that her article would have been stronger had she put that before the part about homeopathy, but it’s true nevertheless.

    And I agree with DW’s concerns about what CVS will sell to make up for the lost tobacco sales. More candy, booze and quackery? Personally, I bet on various products and self-help materials related to quitting tobacco addiction… Most of them useless and/or overpriced. Call me cynical? You bet!

  20. #20 Denice Walter
    February 6, 2014

    @ Orac:

    I think that that was sarcasm.

  21. #21 Denice Walter
    February 6, 2014

    @ Irene Delse:

    I doubt that smoking cessation products will earn enough to make up the huge losses.

  22. #22 JGC
    I keep thinking about a line from the old MTM sitcom
    February 6, 2014

    it was Murray to Ted Baxter, on the occaison Ted briefly did something both brave and generous (before caving in to upper management). “it’s okay, Ted. No one expects a donkey to fly, so we can’t complain if it doesn’t stay up too long.”

    Pulling cigarettes from their shelves is a major good thing, so I’m just going to bask in the surprise and enjoy seeing that donkey aloft while it lasts.

    Tomorrow is time enough to encourage it to take up tap dancing (pulling homeopathic products).

  23. #23 incitatus
    February 6, 2014

    mmm a whole bunch of buttons pushed here. First of all i get very very anxious whenever the capital letters start up. being sceptical is fine. being a Skeptic? whats that, a religion? a, god help us, “movement”? It always puzzles me why people need to have some greater cause to wrap around themselves before they can have an opinion. Strange.
    But letting that slide to one side, assuming that such a ting as a big S Skeptic exists, what would this status have to do with tobacco sales? Unless the Skeptics have some doubts about the link to ill health surely that one is pretty woo free? Or is it one of the tenets that being a Skeptic means you have to want to prevent tobacco sales? and if so why? Surely we need another word, one that actually signifies pro public health measures?

  24. #24 Mark Thorson
    February 6, 2014

    I dounbt if CVS is unaware of the criticism of homeopathy they’re getting. If they decide to drop homeopathic products next month, they’ll dominate another week’s news cycle, and they’ll hardly be giving up any business, unlike tobacco. I think it might happen, and that will be worth it. Everybody knows tobacco is harmful, but not everybody knows homeopathy is worthless.

  25. #25 Lumen
    February 6, 2014

    It is indeed a strange incentive process for the corporations. Doing nothing means at most your brand is mentioned in a vague way lumped together with all companies participating in these practices. However make a small step towards positive change and you will be singled out and held up as the poster child for all that is wrong with your industry. Meanwhile the companies that made no effort at all slide by with barely a foot note.

    I think the key here is the insistence on using terms like “smokescreen”, which imply nefarious and underhanded machinations. The default assumption (I would go so far as to call it conspiratorial thinking) is If a corporation does anything positive then it is only because they are trying to distract the public from other sins and evil deeds. There is a fear or rage that they are trying to deceive us into thinking they are unconditionally good and to counteract this we must immediately go on full attack and prove that this is 1) not a good change, 2) not a genuine heartfelt change or 3) a change that is meaningless and in no way counteracts the companies numerous other evil deeds.

    Rarely do you see the kind of measured response that is outlined here. Namely one that points out that this is a step in the right direction, acknowledges that change comes slowly, praises the good that is being done. Personally I think this is a vital response to issues like these. Why?

    Because it’s providing the needed incentives for further change.

    I don’t think the author of the skepchick piece really thought this all the way through. Using a stick on behavior that merits the carrot is the absolute worst way to get the desired outcome. More importantly I would argue that the carrot was used inappropriately as well. Having read the entire article I did find myself wondering why on earth she *continue to shop at the store* up until now? She basically admits to supporting the store while it engaged in business practices she disagreed with. Then when the store makes a move towards change she attacks them with negative publicity. This is precisely the bizarre behavior that incentivizes corporations to act the way they do. There is no reason to change the status quo, because no good deed goes unpunished.

  26. #26 imr90
    Springfield, MA
    February 6, 2014

    I’ve been getting my prescriptions filled at CVS ever since they bought out the last two local pharmacies around here. I always thought it was inappropriate and hypocritical for a pharmacy to sell cigarettes. When I read of their decision to stop I thought “good for them”. But I agree with Orac and others who have pointed out that there is a significant difference between an addictive carcinogen and candy. Candy and similar products can be “enjoyed responsibly” if they are not staples of your diet.
    I also find it disturbing that they sell homeopathic crap, but I’m willing to fight one battle at a time.

  27. #27 passionlessDrone
    February 6, 2014

    There is a not insignificant percentage of the ‘skeptical’ community that is simply most interested in demonstrating how much smarter they are than cohort that suffers from the burning stupidity du jour. The skepticism handle is simply a means to that end.

    What you are witnessing in the inability of acknowledge a public good by a corporation isn’t about how outraged they are about CVS selling homeopathy; it is about the transient inability to to rant about how they are smarter/more concerned about the public health than someone else and filling that void with something as quickly as possible.

    Of course, this isn’t solely the domain of skeptics, the burning stupid do exactly the same thing.

  28. #28 incitatus
    February 6, 2014

    #25 “there is a significant difference between an addictive carcinogen and candy”

    yes. one is candy.

    I’m struggling a bit though. I am one of those folks who thinks that provided the buyer is aware of what they are buying and provided the social cost is reflected in the buying price then people should be able to buy it.
    This probably means i am not allowed in The Movement

  29. #29 Mephistopheles O'Brien
    February 6, 2014

    Why I don’t care about CVS’s decision: Cigarettes and other tobacco products can be bought at other drug stores, convenience stores, liquor stores, grocery stores, club stores, bars, vending machines, and dedicated tobacco product stores. If the people on both side of me in line at CVS buy 3 cartons of cigarettes each, it harms me not at all. I’m for regulating where people can smoke, as I’ve sat through too many meetings where 2 or 3 smokers fogged up the room. Where they can buy it, not so much.

    CVS does not currently sell e-cigarettes. It would be interesting to see what they decide on that as they remove tobacco products from stock.

  30. #30 Lumen
    February 6, 2014

    #25 “I am one of those folks who thinks that provided the buyer is aware of what they are buying and provided the social cost is reflected in the buying price then people should be able to buy it.”

    This isn’t about what people are “allowed” to buy. This is about a corporation deciding what to sell. They clearly want to be seen as a health center, and have a different business model than 7-11. Selling cigarettes at a health center was undercutting their larger marketing goals. The discussion is about whether that’s hypocritical since they have other practices that ALSO undercut those goals. Are you upset that Doctor’s offices don’t sell cigarettes? No, because you don’t expect them to based on their business model. Currently you think of CVS as a convenience store. It seems pretty clear to me that CVS wants you to think of them differently.

    You’re trying to make this an argument about banning cigarettes. It’s not.

  31. #31 Alison Cummins
    Montreal QC
    February 6, 2014

    Another way to view the hypocrisy:

    Orac: CVS is doing a terrible thing by selling homeopathy.
    Shruggie: Why are you being so critical, they sell useful medication too!

    We would consider Shruggie to be changing the subject unhelpfully. In the same vein, switching the conversation from tobacco to soft drinks is changing the subject unhelpfully.

  32. #32 Denice Walter
    February 6, 2014

    I’ve recently seen figures that show that only 18% of adults in the US now smoke.
    That’s not a sign of a popular trend.

  33. #33 Roadstergal
    February 6, 2014

    I doubt that smoking cessation products will earn enough to make up the huge losses.

    Anecdotally – when they banned cigarette advertising from motorcycle racing, energy drinks were one of the main sponsors to step in and fill the void. I wonder how revenue from the latter stacks up to revenue from the former.

    Which is fine with me. They might be overpriced and not terribly healthy, but they’re not effing potent carcinogens…

  34. #34 incitatus
    February 6, 2014

    #30 Lumen im sorry but CVS to me is three letters in a row- i have no idea who or what they are. But actually the language i was using was all from the original blog post. In there we have it being “good” to stop selling cigarettes, which is noted as a position that is equated with Skepticism. You really need to actually read what is being discussed you know. For example:
    “the move by CVS is huge and is to be praised.”" “CVS is in the healthcare business and shouldn’t be selling something as harmful to health as tobacco.”"

    this is clearly viewpoints in favour of not selling tobacco. So basically you are talking rubbish.

    But within the rubbish you are talking, why should a pharmacy not sell tobacco, provided it is labelled correctly? Why should they not sell chainsaws or aardvaarks?

  35. #35 Irène Delse
    February 6, 2014

    I just noticed something: Orac and others seem to react mostly to the word “smokescreen” in Heina’s post, and point out that stopping entirely to sell tobacco products and becoming more of healthcare business is a big step for the company to take. Which is true, but didn’t you notice that “smokescreen” was how Heina characterized CVS Care’s communication, the spin they were putting on their business decision, not the decision itself? It’s right there in the title: “Why #CVSQuits is a smokescreen”, wrt a tweet and hashtag from the company.
    I hope you see the irony of talking about knee-jerk reactions in those circumstances!

  36. #36 Karl Withakay
    February 6, 2014

    Perfect must not be the enemy of good, better, or even motion in a positive direction. (Perhaps even without much regard to the motivations behind that motion, if it is significant enough.)

    Does this give them a free pass on anything? Certainly not, but why send the message, “F U, if you don’t change everything right now the he way I want it, you may as well not bother making any changes.”

    The comments on the Skepchick article are just as bad as the post:

    “Maybe this is just the stores in my city, but both the CVS and the Walgreens have a prominent display right near the pharmacy desks with exclusively Christian self-help and inspirational books.”

    …and this is relevant exactly how? Reasons to not like CVS as a corporation or employer are not the same things as suppor tfor the claim that an action they take is just a publicity stunt rather than a legitimate attempt at changing at least one aspect of their business to better align with that of a company focusing on health care. They may be the antichrist of employers, but that’s not really relevant to the topic at hand.

  37. #37 Karl Withakay
    February 6, 2014

    @Irène Delse:

    From the Skepchick article in question,

    “CVS Caremark, the company that owns the CVS Pharmacy chain, has announced that CVS stores will be phasing out the sales of tobacco products. The move is an excellent publicity stunt, but, in my view, not terribly meaningful in terms of helping people’s health”

    Read beyond the post’s title. It’s right there in the post itself in the very first paragraph.

  38. #38 Orac
    February 6, 2014

    Exactly. To her CVS Caremark’s action is a “smokescreen” and a “publicity stunt,” not a meaningful statement or action. It’s not just the Twitter hashtag she’s talking about; it’s the decision itself. Then she goes on to rant about what she hates about CVS, listing things that have no relevance to the decision to drop the selling of cigarettes and other tobacco products.

  39. #39 Orac
    February 6, 2014

    In there we have it being “good” to stop selling cigarettes, which is noted as a position that is equated with Skepticism.

    It is good for a company that represents itself as a health care company not to be selling products that are very bad for your health. Moreover, what I complained about is how skeptics don’t accept this decision alone as good (and, as a physician, I view it as good) but seem obsessively compelled to couple it with something that CVS is still doing that they don’t like.

    Are you saying that it’s not good that a company whose core business is pharmacy decided to stop selling cigarettes? It was a decision that was not coerced, a decision the company was perfectly free to make if its leadership saw fit.

  40. #40 Pete Attkins
    UK
    February 6, 2014

    It seems that too many skeptics are devoid of critical thinking skills. CVS estimates the short-term loss of sales (and corresponding reduction in share price) will be 1.3 to 2%, but it “believes the decision will strengthen its position as a healthcare provider.” That’s hardly a risky financial decision, it is a logical decision that will remove the obvious hypocrisy of a healthcare provider selling products that cause morbidity and mortality.

    A seemingly commendable decision, but smokers do not purchase tobacco products impulsively just because they happen to see them for sale in a store. Selling tobacco products is not recommending these harmful products because everyone already knows they are harmful.

    A pharmacy selling useless health products is very much recommending the products because it is not general knowledge that the products are useless and indirectly harmful.

    Selling tobacco products is a very different type of hypocrisy from selling useless health products therefore it is impossible to determine which of the two is worse. I suggest that the former type is overtly ironic (cringeworthy) and the latter type is insidious (stealthy marketing).

    Comparing the damage done by each type of product is a red herring fallacy because smoking is caused by addiction. To determine if the decision by CVS to withdraw tobacco products from sale is actually a commendable decision we would need data showing that the likely result will be a statistically significant drop in the number of smokers.

  41. #41 Woo Fighter
    February 6, 2014

    I’m surprised nobody from Canada has chimed in yet. Up here, the chain pharmacies (equivalent to CVS and Walgreen’s) eliminated all tobacco products from their stores years ago, a move that was universally accepted and applauded.

    In the mall where my mom buys her prescriptions at a Pharmaprix (Shopper’s Drug Mart outside of Quebec) there are six adjacent stores that sell ciggies. My mom, a smoker, has never had trouble buying her smokes at any number of adjacent shops.

    A family friend, who has a Pharmaprix francise, told us they make almost nothing on cigarettes, but they did used to bring people in to the store who might buy a candy bar, or a newspaper, or something else their competition also sells. He said the loss of cigarette sales had virtually no effect on his profits, and the hassles associated with selling cigarettes weren’t worth the slim margin he made. Up here, any buyer who appears under 25 has to be carded, and any store that stocks cigarettes is a huge target for robberies. Especially as more and more pharmacies stay open very late or 24 hours, and as the prices and taxes of tobacco products continue to skyrocket.

    On the shelves that used to stock cigarettes he now stocks more profitable items, which he is allowed to display prominently behind the cash registers, which leads to more impulse purchases and more profits.

    I should explain that last comment: in my province cigarettes are not even allowed to be displayed openly anymore. They are hidden behind solid panels and not visible. Stores cannot even put up any merchandising or promotional material like posters, counter stand-ups, or signage.

  42. #42 The Very Reverend Battleaxe of Knowledge
    February 6, 2014

    To determine if the decision by CVS to withdraw tobacco products from sale is actually a commendable decision we would need data showing that the likely result will be a statistically significant drop in the number of smokers.

    How are they going to ensure that? They can’t go out on the street and knock cigarettes out of peoples’ hands. They can’t ban tobacco from the marketplace. Even in America we don’t give corporations that kind of power (yet). You have to be elected mayor of New York or something….

    Their decision to stop selling tobacco can’t be commendable unless everybody else does the same thing? I’ve never seen this kind of standard applied anywhere else.

  43. #43 Karl Withakay
    February 6, 2014

    “That’s hardly a risky financial decision, it is a logical decision that will remove the obvious hypocrisy of a healthcare provider selling products that cause morbidity and mortality.”

    For a publicly traded corporation, committing to a 1.3 to 2% short to intermediate term reduction in sales is absolutely a risky and bold financial decision. That’s the kind of thing that can get CEOs fired and boards replaced.

    “Selling tobacco products is not recommending these harmful products because everyone already knows they are harmful.”

    Selling harmful products is participating in the harm. As long as someone else is selling heroin, I may as well also and profit from it, since everyone already knows heroin is harmful, right?

    “To determine if the decision by CVS to withdraw tobacco products from sale is actually a commendable decision we would need data showing that the likely result will be a statistically significant drop in the number of smokers.”

    Nope. See my comment above about selling heroin. It is commendable to say, “Not from my hands; I won’t participate in that anymore. I’d rather loose a couple of billion dollars.”

  44. #44 Dave Ruddell
    February 6, 2014

    @Woo Fighter, you statement:

    “Up here, the chain pharmacies (equivalent to CVS and Walgreen’s) eliminated all tobacco products from their stores years ago, a move that was universally accepted and applauded.”

    misses the very important point that this was done by legislation, and not voluntarily by Shoppers and Rexall.

  45. #45 Lumen
    February 6, 2014

    #34

    The answer is in one of the very sentences you quoted. Chainsaws and aardvaarks when used correctly are not detrimental to people’s health. Cigarettes when used as instructed ARE. CVS is in the business of HEALTH CARE therefore, it is not in keeping with their advertising message that they should sell you a product that is solidly proven to harm your health.

    The argument is it sends mixed messages regarding the product. Even if labeled there are plenty of people who will still think “well if they sell it at the pharmacy it can’t be THAT bad for you”. Here is a quote from the CEO’s twitter :
    “It’s time for retailers w/ pharmacies to stop sales of tobacco products – CMO Brennan”

    As you can see they are very clear about this being an issue specifically regarding drug stores. Not retailers in general.

    It’s a related thought process with homeopathy. Even though it is clearly labeled that the claims are not approved by the FDA, having it in a store that sells legitimate health care products sends a confusing message to consumers.

    My reading of the essay, and the issue in general is Orac was addressing a knee jerk reaction amongst skeptics to rage about CVS carrying homeopathic snake oil, not because they don’t think the tobacco issue is important but because they want CVS to engage in MORE policies like this, or they think that Homeopathy is a bigger issue (or income inequality or food deserts etc). The link to skepticism is not that ALL Skeptics are on the anti-tobacco platform, but because many skeptics are disregarding the tobacco move while clamoring about homeopathy, which is a more commonly accepted “skeptical” issue. This despite the fact that the argument about pharmacies selling homeopathy is actually a bit weaker than the tobacco argument (after all homeopathy does not cause direct harm). After all homeopathy is “labeled” as well with the quack miranda warning.

    But I would also add that there appears to be a knee jerk libertarian reaction that wants to make this about individual choice when it is not. This is about a specific company agreeing that marketing themselves as a health care center means they should probably act like a health care center and not carry products that are proven to be unequivocally and actively detrimental to your health. Doing otherwise undercuts their believability as a health care center, and they’ve decided that means more to them in the long run. CVS as a private corporation is under no obligation to act as a convenience store, provide cigarettes, provide aardvaarks, and I know this will upset many… they don’t even have to sell chainsaws.

    Now if only we can convince the History Channel to program shows about history…

  46. #46 Gingerbaker
    February 6, 2014

    Really, I have to love the self-congratulatory enthusiasm here for eliminating consumer choice in the name of morality. If we can’t actually convince someone to quit smoking, let’s make it as inconvenient as possible for them to continue to procure a legal product we don’t happen to like.

    Straight out of the pages of of the Republican playbook, isn’t it, just like eliminating funding for Planned Parenthood clinics to reduce abortion rates.

  47. #47 Lumen
    February 6, 2014

    How is government funding for planned parenthood at all related to how a corporation is choosing to market itself? CVS does not want to be associated with tobacco, because being perceived as a merchant that offers health care products is apparently more important to their long term business plan, than short term profits from cigs.

    Consumer choice is in no way eliminated. There are plenty of businesses that are happy to sell you cigarettes if you would like them.

    Stop trying to spin corporate decisions based on consumer pressure as some sort of nanny state. This is precisely how the free market works.

  48. #48 JGC
    February 6, 2014

    Even if labeled there are plenty of people who will still think “well if they sell it at the pharmacy it can’t be THAT bad for you”.

    Same reason there’s all those old TV and print ads from the 1950′s and 60′s with doctors (real or paid actors) shown smoking or actively pitching a brand (“Hey, if doctors smoke it can’t be all that bad for you, right?”)

  49. #49 Orac
    February 6, 2014

    For a publicly traded corporation, committing to a 1.3 to 2% short to intermediate term reduction in sales is absolutely a risky and bold financial decision.

    Indeed. Pete appears not to know how publicly traded corporations work here in the US. If the profits at CVS drop as a result of this decision, you can bet that the CEO and chair of the board of directors will have their feet held to the fire by the investors at the next investors meeting. Making a decision that reduces revenue by 2% is a huge deal; if it doesn’t pay off in a couple of years, the CEO might have to start looking for another job.

  50. #50 Orac
    February 6, 2014

    Stop trying to spin corporate decisions based on consumer pressure as some sort of nanny state. This is precisely how the free market works.

    Don’t you know? The latest conspiracy theory is that the decision by CVS wasn’t entirely voluntary, that it was made necessary by—you guessed it!—Obamacare:

    http://crooksandliars.com/2014/02/fox-news-wonders-if-cvs-can-legally-halt

  51. #51 Orac
    February 6, 2014

    …and this is relevant exactly how? Reasons to not like CVS as a corporation or employer are not the same things as suppor tfor the claim that an action they take is just a publicity stunt rather than a legitimate attempt at changing at least one aspect of their business to better align with that of a company focusing on health care. They may be the antichrist of employers, but that’s not really relevant to the topic at hand.

    It reminds me of what everybody’s favorite questionable supporter of SBM, the ACSH, said in response to the CVS decision:

    http://acsh.org/2014/02/cvs-good-thing-maybe/

    Yes, ACSH immediately took the CVS decision and made it about e-cigarettes, just as some skeptics are taking the decision and making it about selling homeopathy.

    To ACSH, which for reasons that still escape me, fetishizes e-cigarettes as the greatest thing to hit smoking cessation ever, to the point that hardly a day goes by without ACSH praising e-cigs to high heaven and attacking anyone who questions their value, it’s great if CVS stops selling cigarettes, but if it stops selling e-cigarette and e-cig supplies, it’s killing smokers by robbing them of a tool to quit. Never mind that e-cigs have as yet to be convincingly demonstrated to be an effective smoking cessation tool and that e-cigs and supplies are now mostly manufactured by big tobacco.

    http://scienceblogs.com/insolence/2013/08/19/jenny-mccarthy-and-the-selling-of-e-cigarettes/

  52. #52 Lumen
    February 6, 2014

    I think it will be really interesting to see if it DOES pay off. I actually shop at CVS all the time, and I had no idea that I could go get any vaccine other than the flu shot there, until my doctor told me about it today. (we were discussing getting a Tdap) Now that I know about this minute clinic thing I’m more interested since my doctor often has long waits. But I admit all the other gak that they sell makes going there for legitimate health care seem kind of sketchy, which is why I’m curious to see if there are more changes coming down the pike as they try to reposition themselves in the marketplace.

  53. #53 Narad
    February 6, 2014

    It appears that the $1.5 billion figure cited is for revenue, not profit. I’ll have to look further at this, but this story broke locally before it went national, and my first response was that it jibed extremely well with their aggressively moving toward eliminating cashiers entirely in favor of self-checkout.

  54. #54 Orac
    February 6, 2014

    Well, I didn’t say it was $2 billion in profit, but rather $2 billion in sales.

  55. #55 Mewens
    February 6, 2014

    @Gingerbaker

    So you’re saying CVS shouldn’t have the decision whether or not to carry cigarettes?

    Keep in mind that CVS made this decision; it wasn’t reacting to legislation.

    Seems to me like you’re the one doing the moralizing here.

  56. #56 Victor Prime, the Ghost-Who-Waddles
    February 6, 2014

    Gingerbaker @ #46

    A company making a decision is not “limiting consumer choice” nor is it some hideous destruction of freedom. Go back to the Young Randites’ Club at your community college and leave us be.

  57. #57 Todd W.
    http://www.harpocratesspeaks.com
    February 6, 2014

    Reading Orac’s post, and not having heard about CVS’ decision beforehand, my reaction was, “Great! I can fully get behind that.” I didn’t react with, “That’s nice, but look at all this other horrible stuff they still do! Such dastardly deeds!”

    I understand this was a (risky) business decision that they hope will pay off down the road with their revamped image as a health care provider, and I’m not under any illusions that it was driven with consumer health as the top impetus, though that’s certainly a consideration. It’s not a completely altruistic act. But that doesn’t mean that it should be discounted by basically saying, “Oh, well, that’s nice. But you’re such an a**hole because…”

    As for Gingerbaker’s, uh, interesting arguments, if I understand you correctly, you’re opposed to companies operating in the free market and making their own policies? Or are you suggesting that the government is forcing them to do this? It’s difficult to understand your logic, such as it is.

  58. #58 Narad
    February 6, 2014

    Yep, reports are that this represents a loss of 6–9 cents on earnings per share, which is currently sitting at $65.94, or about 0.11%. Compare with the straight revenue figure cited in the media, which is “$2 billion”/$123 billion, or 1.63%.

  59. #59 Orac
    February 6, 2014

    Now if only we can convince the History Channel to program shows about history…

    Well, it still sort of does, just not on The History Channel proper. It now farms out the real history shows to its subsidiaries, like Military History, leaving the more profitable reality shows like Pawn Stars (which really has nothing to do with history) on the main channel.

    To be honest, I kind of miss the days when The History Channel used to be referred to as The Hitler Channel because of all the World War II documentaries and documentaries about Nazi Germany that it used to show… :-)

  60. #60 Todd W.
    http://www.harpocratesspeaks.com
    February 6, 2014

    Pawn Stars (which really has nothing to do with history)

    What are you talking about, Orac? It’s a show about stuff that people used to have…in the past. Therefore, history!

  61. #61 Antaeus Feldspar
    February 6, 2014

    Another way to view the hypocrisy:

    Orac: CVS is doing a terrible thing by selling homeopathy.
    Shruggie: Why are you being so critical, they sell useful medication too!

    I wouldn’t be so quick to use that word “hypocrisy”. The two situations you are trying to compare look similar, but they are in fact very different.

    For simplicity’s sake, let’s talk about the acts “G” and “B”, and specify that “G”, whatever it is, is a good act, but “B” is a bad act whose badness outweighs any good from “G”. Compare the following two dialogues:

    Person 1: James does B.
    Person 2: So?? James also does G!!

    Person 3: James does G.
    Person 4: So?? James also does B!!

    Person 2 is clearly “changing the subject unhelpfully” – but is Person 4 doing so, just because their statement occupies the same position in the conversation as Person 2′s?? I don’t think so. If one of our starting premises is that the badness of B outweighs the goodness of G, then clearly whoever’s talking about B is being more relevant to the subject of James’ moral standing – whether they go first in the conversation or second.

    For the record, *I* think this is a very good thing to happen, and that CVS should be applauded for taking such a step (and thus encouraged to take similar steps in future) even if we suspect or *know* that they are doing it for branding purposes more than anything else. The premise that I put forth for the sake of argument, that B outweighs G, is one I do *not* believe holds true when “G” is “stops selling cigarettes” and “B” is “still sells soft drinks”; I believe the health impact of tobacco products far outweighs that of soft drinks (a view that I freely admit may be biased by me relying on soft drinks daily, while never even being tempted to try cigarettes.) But even if someone disagrees with my positions on this matter, I’d be very careful about calling them a hypocrite just because I don’t see the consistency in the positions right off.

  62. #62 Beana
    February 6, 2014

    I used to smoke, and the absolute worst, most stale cigarettes were at the pharmacies. (back when they were like $4 a pack)

    All of the CVS’s closed in my surrounding area some years ago. I never found out why? Maybe Walgreens and Rite Aid were too far entrenched? I would readily shop at CVS, but there aren’t any :( I hope it pays off for them.

  63. #63 Andreas Johansson
    February 6, 2014

    A seemingly commendable decision, but smokers do not purchase tobacco products impulsively just because they happen to see them for sale in a store.

    Why, then, are tobacco products prominently displayed just at the tills, right next to impulse-buy stuff like candy? That’s a serious question, BTW. The till proximity may be down to security (I imagine cigarrettes has among the more pointful things to steal in a convenience store), but the prominence is if anything contraproductive in that regard.

    (ObAnecdote: at a store I used to regularly shop, the cigarrettes were in a metal box above the tills, positioned so that the taller customers regularly banged their heads into it – they even glued a big pink piece of foam to it to soften impacts. When asked about it, the staff told me that they had a contract with the tobacco distributor requiring them to have it right there.)

  64. #64 Pete Attkins
    UK
    February 6, 2014

    @Karl Withakay
    It appears that you either did not read or did not understand the salient points in the article to which Orac linked.

    In the UK and the US the sale of heroin is a criminal offence therefore it has nothing whatsoever to do with company decisions concerning the sales of the legal products: tobacco; alcohol; and many bogus (but legal) health products.

    My opening statement was: It seems that too many skeptics are devoid of critical thinking skills. I have no objection to anyone stating their opinion(s) when making it clear that it is just their opinion, however, I totally agree with Orac in that knee-jerk reactions by skeptics serves only to give skepticism a bad name. Such skeptics are just outspoken critics using rhetoric instead of critical thinking skills.

  65. #65 Karl Withakay
    February 6, 2014

    Narad:

    “Yep, reports are that this represents a loss of 6–9 cents on earnings per share, which is currently sitting at $65.94, or about 0.11%. Compare with the straight revenue figure cited in the media, which is “$2 billion”/$123 billion, or 1.63%.”

    Make sure you’re using all the right numbers. That 0.11% is what percent of the share value the loss represents (ie, the yield.), not the percent of earnings or per share earnings.
    Earnigns per share is/are $3.59. 6-9 cents represents 1.67-2.5% of earnigns per share.

    The current dividend yield on a share of CVS stock is $1.10. The 6-9 cent loss of earnings per share represents ~5-8 of the per share dividend.

  66. #66 Karl Withakay
    February 6, 2014

    @Pete Attkins

    “@Karl Withakay
    It appears that you either did not read or did not understand the salient points in the article to which Orac linked.”

    Nope. I did, and I do.

    “In the UK and the US the sale of heroin is a criminal offence therefore it has nothing whatsoever to do with company decisions concerning the sales of the legal products: tobacco; alcohol; and many bogus (but legal) health products.”

    Legality is not really relevant to my statement. I’m sorry that you weren’t able to look beyond the limitations of my analogy and understand my greater point. Please try to consider this revised statement:

    ” As long as someone else is selling something severely harmful, I may as well also and profit from it, since everyone already knows that thing is harmful, right?”

  67. #67 Narad
    February 6, 2014

    I understand this was a (risky) business decision

    Not really, according to CVS: “We’re not changing our 2014 financial earnings guidance as part of this announcement.”

    As to whether pointing to everything else that they sell that is either fraudulent (homeopathy) or unhealthful (junk food, sugary beverages), the calculus would seem to involve where the real hit to the bottom line is, rather than blandishments such as

    We think this is the right decision at the right time as we evolve into more of a health care company, and I think it puts an exclamation point on the fact that we are serious about the role that we play in the health care delivery system…. I think we had to look in the mirror and ask ourselves some very pointed questions, and that’s where we came to the conclusion that, yes, there is a contradiction.

    Well, if there are more profitable contradictions, I see no issue in observing the fact, so long as it’s documented. CVS/Caremark indeed has been positioning itself as “more of a health care company”: locally, they have an exclusive deal with the U. of C.’s “not formally an HMO” in-house health plan as the sole non–in-house mail-order Rx supplier, which is a cushy position to be in when the only retail-pharmacy option available for recurring prescriptions is the one operated by the university.

  68. #68 Narad
    February 6, 2014

    Make sure you’re using all the right numbers. That 0.11% is what percent of the share value the loss represents (ie, the yield.), not the percent of earnings or per share earnings.

    You’re correct; the “EPS value” that I cited was a product of my precaffeined brain, but even then I should have noted the outrageous discrepancy. The FY 2012 EPS was $3.03, so 2.8%.

    Thanks for the correction.

  69. #69 Todd W.
    http://www.harpocratesspeaks.com
    February 6, 2014

    @Narad

    So, they did not see it as risky from a sales perspective, but what about the publicity/shareholder perspective?

    I’ll revise my statement to “(potentially risky)”.

  70. #70 Pete Attkins
    UK
    February 6, 2014

    @Orac comment #49
    “Indeed. Pete appears not to know how publicly traded corporations work here in the US. ” Or perhaps Pete does know how they work and, in particular, how their corporate PR works :-)

    It seems that even you missed the many clues in the article to which you linked. I totally agree that if the decision turns out to be poor in two years then heads may roll, but these kinds of decision were not made by just the CEO and the board during a discussion of their opinions.

    It wouldn’t be appropriate to walk through each clue in your linked article and offer my reasoned explanation in this comment thread. I’m more than willing to discuss it via e-mail, but there is little point because we don’t have a difference of opinion, we just have very different ways of expressing our similar opinions and observations.

    Your introduction to this article shows that you were expecting dissent so perhaps you are reading my comments as dissenting rather than my attempt to be supportive.

    I try my best to promote critical thinking in all walks of life, and especially in the fields of physiological and psychological health care, but my efforts are often rendered almost pointless by the knee-jerk reactions of self-proclaimed skeptics who are just outspoken critics masquerading as skeptics — which was, I thought, the fundamental point of your article.

  71. #71 Johnny
    127.0.0.1
    February 6, 2014
    Now if only we can convince the History Channel to program shows about history…

    To be honest, I kind of miss the days when The History Channel used to be referred to as The Hitler Channel because of all the World War II documentaries and documentaries about Nazi Germany that it used to show…

    Yeah, well, I’m so old that I rember when MTV and VH1 played music. In fact, I remember when they started – I was traveling a great deal and spending weeks in hotels. It was a strange concept, but I found a lot of new music on those channels.

    The first I heard of the CVS announcement, it only said that they were dropping tobacco. I didn’t think much of it, and figured it was part of the ‘war on cigarets’, and if someone had asked my opinion, I’d have said ‘good for them, it looks like people really are quitting’.

    Later when I heard some CVS exec say it was because ‘we care about our customer’s health’, I must admit my first thought was “But… homeopathy?!!????!”.

    I suspect that, like any corporation, that they expect it to pay off in the long run, and that this is just a bit of marketing. I don’t think that CVS dropping tobacco will prevent a single smoker from starting, or help a smoker stop, or even cause one to slow down any. But it sure has us talking about the company.

  72. #72 Narad
    February 6, 2014

    So, they did not see it as risky from a sales perspective, but what about the publicity/shareholder perspective?

    Publicity is ephemeral. This afternoon, Wisconsin Public Radio did an hour-long segment on the topic. There were the usual handful of callers stating that they were switching to CVS as a result. This is of little consequence, as the Walgreens/CVS trade-off among nonsmokers is driven by proximity and loss leaders. (The local CVS has an atrocious selection compared with the local Walgreens, whose product selection also went to hell after a recent remodeling, but it’s impossible to generalize from this anecdata point.)

    The question, to my mind, remains what you’re going to do with the space behind the counter* otherwise. This isn’t much of a problem for CVS to the extent that they’re getting rid of the counters in the first place. But what’s Walgreens going to do? Move the razor blades back there? Several years ago, the local one tried moving back the batteries, which was a disaster, since the shelf tags aren’t readily visible and they wound up having to shoo away customers edging up behind to try to suss out the unit prices. These eventually moved back to the regular shelves, with loss-prevention locks on the racks for easily pocketable, overpriced items such as button batteries.

    I don’t really see anything to applaud here. One argument that I’ve heard trotted out is that making access more inconvenient drives lessened consumption. I would counter that it’s entirely likely that it would drive carton purchases, which lead to increased consumption.

    * The space in front is of course high-margin unit candy and gum.

  73. #73 AdamG
    February 6, 2014

    Pete Attkins:

    A seemingly commendable decision, but smokers do not purchase tobacco products impulsively just because they happen to see them for sale in a store.

    This unsupported assertion is actually false.
    http://www.ncbi.nlm.nih.gov/pubmed/23640986
    http://www.ncbi.nlm.nih.gov/pubmed/24365702

  74. #74 jre
    February 6, 2014

    Henceforth, all tobacco products sold in CVS stores shall contain only homeopathic tobacco.
    Next problem?

  75. #75 Narad
    February 6, 2014
    A seemingly commendable decision, but smokers do not purchase tobacco products impulsively just because they happen to see them for sale in a store.

    This unsupported assertion is actually false.

    Not until one breaks out “smokers.” Youth and people trying to quit appear to represent a reasonable interpretation (PDF).

  76. #76 Mikee
    February 6, 2014

    Yes, yes, yes Orac. Great post.
    It is knowing that there are skeptics like you who actually think about how our messages are best communicated, which keeps me involved in skepticism. I think too much scolding not only alienates others, it drives some people out of our communities.

  77. #77 Bob G
    Los Angeles
    February 6, 2014

    I read the article on the Skepchick site and I have a distinct ambivalence about the article and about the attacks on it here on RI. I understand full well the notion that people on the political left (for lack of a better term) can be overbearing, smug, and superior. Finding fault with a major corporation that has just agreed to stop selling cigarettes is obviously a stretch. It’s not a panacea for the tobacco problem, but at least it is one less big box store that is peddling the little killers.

    All that having been said, I am sympathetic to the plight of people who work in big box retail and get jerked around in terms of their working hours. It’s very common for the staff to have extremely variable hours not only from one week to the next, but from one day to the next. Think about working till past closing time when closing time is 9 PM and then having the dawn shift the next morning at 7:30 AM. It’s stressful and potentially injurious to live like that. I would ask whether CVS is unionized, or whether the corporation has resisted labor organizing with all the evil tricks that are legal here in the United States. That would be more pertinent to me in terms of whether I believe anything at all about the corporation’s claims of benevolence toward mankind.

    I also recognize the issue of selling sham remedies right next to pharmaceutically active OTC products, without giving disclosure to the buying public that such products are essentially useless for what ails them. I go to a pharmacy that peddles that pseudo-treatment for catching cold while flying, even though it is a useless mixture of vitamins and whatnot. They also sell that homeopathic “remedy” for colds and flu right next to the cough drop selection. I think that this is dishonest, but apparently there is some demand for these products and there must be some sales. I doubt that any of these make up any appreciable fraction of pharmaceutical profit, but still they are available. What annoys me is the implied promise by the pharmacy that these products are effective, in the same sense that an antihistamine or an aspirin product is effective. I notice that the pharmacy does not explain that homeopathic products are just sugarwater pills.

    For all of these reasons, I think it’s fair to point out that pious sounding pronouncements by corporate PR are not to be taken seriously. They continue to abuse their workers (as many big box stores do), and they sell useless products with the implied promise that such products are effective. It’s the abuse of the workers that is a serious problem as far as I’m concerned, and I think it’s fair for a former employee to point that out.

    It’s also fair to point out that the big box retailers are all complicit in the act of keeping workers below the number of hours that makes them benefits-eligible. In the U.S., this meant the lack of health insurance prior to the ACA, which we all know about. It is fair to paint the mass of American corporate big box retailers as political activists in the anti-labor and anti-health coverage movement. I think we have all become a little numb to their political power, and it shouldn’t be a social faux pas to mention it every now and then.

    As for the rest of the critique, I don’t see this article as being an element of skepticism either as a movement or as a belief system. Skepchick just happens to be the pulpit that this particular woman has available, hence the intersection of her interests and the blog itself. Other remarks about religious literature being sold at CVS are actually appropriate to the Skepchick readership, although of less interest to me.

    In short, I see this whole thread as a bit of an overreaction to what is, after all, some personal remarks by a little known writer on a blog that is only modestly known. Perhaps I’m being a little insensitive to people who have to deal with public smoking. Here in California, we’ve been blessed with a pretty-near total ban on public smoking for some time, and restaurants have had nonsmoking sections for decades — and now of course are totally non-smoking. Even Italy has a fairly effective ban on indoor smoking in some places, showing that the world is capable of learning.

  78. #78 Narad
    February 6, 2014

    I would ask whether CVS is unionized, or whether the corporation has resisted labor organizing with all the evil tricks that are legal here in the United States.

    You mean like forcing employees to sit through presentations designed to put them off organizing or firing 100 people prior to a vote (PDF)?

  79. #79 Orac
    February 6, 2014

    In short, I see this whole thread as a bit of an overreaction to what is, after all, some personal remarks by a little known writer on a blog that is only modestly known.

    This post was not a reaction to the Skepchick post. I wrote it before I ever encountered the Skepchick post. You see, I frequently write my posts the night before but let them sit overnight, so that I can check them briefly first thing in the morning. It’s a good way to keep me from posting something…unwise…in the heat of the moment. Well, this morning, after having written the post the night before, I came across the Skepchick post. It irritated me; so I added a little commentary on it and quoted a paragraph from it. Had that post never been written, I still would have written this post.

  80. #80 Lurker
    February 6, 2014

    It may be true that alcohol can be ‘enjoyed in moderation,’ but it also produces violent deaths of innocent people on a large scale: half of all murders, suicides, and automobile fatalities. Unlike dealing with smokers, those victims don’t have the chance to ask, ‘do you mind not doing that here?’

    One in four families suffers from having an alcoholic in the family. Alcoholism is one of the top three destroyers of families, and the impact on children is especially severe.

    Cigarettes are the low-hanging fruit of public health, so I’m frankly cynical about politicians and corporations seeking to score easy points on smokers whilst doing nothing to discourage alcohol abuse and even (sorry Orac) offering the excuse that moderate drinking is OK. Cigar and pipe smoking are ‘moderate smoking,’ so consistency requires treating them in the same manner as ‘moderate drinking.’ Shall we go there?

    CEOs of major publicly-traded corporations do not take decisions that are calculated to cost the shareholders money, lest they be sent packing the next day. You can be certain that CVS’ no-tobacco policy was only adopted after surviving the test of the spreadsheet. Per _Wired Magazine_ online, CVS is most likely responding to Amazon’s efforts to eviscerate the bricks-and-mortar trade, by refashioning itself as a ‘wellness centre.’ Right. I’ll believe them when they pull the alcohol from their shelves, as you can be sure that alcoholics are over-represented among those who pop into a pharmacy for a six-pack or a bottle of cheap wine.

    This isn’t a matter of complaining about someone’s weight when they tell you they’ve decided to stop smoking. It’s about complaining that they still haven’t stopped driving under the influence.

  81. #81 Orac
    February 6, 2014

    Cigar and pipe smoking are ‘moderate smoking,

    This “moderate smoking” puts the user at high risk for nasty head and neck cancers, and most pipe smokers inhale, producing the same risks as cigarettes.

    I’m also puzzled at what’s wrong with going after the “low hanging fruit.” That’s what we almost always have to start with because it is the low hanging fruit. Few are those who go after the difficult targets first. It rarely makes sense to do so. For example, when we seek to improve processes at our cancer hospital, we don’t usually go after the hard stuff first. We work up to it by going after the “low hanging fruit” first.

  82. #82 Mephistopheles O'Brien
    February 6, 2014

    Andreas Johansson – in my area cigarettes are next to the till so that the sales clerk can hand them to the customer after checking proof of age.

  83. #83 Doctor Biobrain
    February 6, 2014

    I think the problem is with people who see everything as a struggle between good and evil, and that you’re either on one side or the other. So if someone does something truly bad, it means we must ignore any good they’ve done because of the bad.

    But nobody is all good or all evil. Nobody is perfect or completely imperfect. So we praise the good while seeking to fix the bad, and yeah, if you pile on someone for doing the right thing because it’s not enough, it just makes the person feel like they can’t win. We’ve probably all had bosses that have done that to us, so no matter how much we get right we only hear what we did wrong. Well…that’s exactly what these people are doing and it totally sucks and is counterproductive.

    Of course, the concept of a straightforward action being counterproductive entirely eludes such people. That’s why they often imagine that you can somehow insult someone into agreeing with you. But…you can’t. Every insult you give only makes people less likely to listen to anything you say, and is therefore counterproductive. And the only purpose an insult serves is to make you feel better while making the world a worse place. And sadly, I’ve been insulted by people just for saying that.

  84. #84 Doctor Biobrain
    February 6, 2014

    Anyone lumping cigarettes with booze and junk food are wrong about the science, period. Tobacco in moderation is dangerous. Booze and junk food in moderation are not. And it’s not even close.

    And it’s all based on a fallacy some in the medical community have pushed, that if something in large amounts is dangerous than it must also be dangerous in smaller amounts. And…no, that’s not how life works. Anything taken to excess can kill you, including water and oxygen. And the question is what levels are safe.

    Tobacco smoke is poison in any amount. Does it mean you’ll get cancer? Not necessarily, but even chain smoking five packs a day won’t guarantee cancer either. But it’s a poison at any amount. Alcohol, on the other hand, taken in moderation is healthier than abstaining; or so says the latest medical research. Not even just wine, but beer as well. It’s the people drinking a fifth of Jack or a sixpack of Bud every day that show the problem with alcohol. But taken in moderation, it’s healthy. Or so says science.

    And even junk food in moderation isn’t bad for you. Eating a whole bag of Cheetos with your 64 oz Big Gulp will cause you problems. But there’s no science showing that these things in small quantities is harmful, and anyone who says otherwise is just making things up; whether they know it or not. The science just doesn’t support them, and I go with science every time.

  85. #85 Narad
    February 6, 2014

    I’ll believe them when they pull the alcohol from their shelves, as you can be sure that alcoholics are over-represented among those who pop into a pharmacy for a six-pack or a bottle of cheap wine.

    The local CVS can’t sell alcohol despite their original plan, because the liquor store in the same plaza objected. Taking Walgreens as a closest comparison, it seems like a dubious bet for alcoholics, as everything is wildly overpriced and you’re certainly not going to get a $3 pint of cheap vodka.

    I can’t even figure out why they bothered after a lapse in their liquor license of nearly 10 years, since they don’t sell after 10 p.m., which is the closing time of the grocery store next door, which is merely really overpriced.

    So, no, I don’t believe that alcoholics are overrepresented at drug stores.

  86. #86 Doctor Biobrain
    February 6, 2014

    Oh, and one big problem I have is with people who confuse skepticism with cynicism. So they hear a story like this and their cynicism kicks in and they start searching for some hidden purpose to this which only proves that corporations cannot be trusted.

    But sorry, that has nothing to do with skepticism. If you’re starting with the premise (eg, corporate pharmacies are evil), and use that to figure out a way to criticize them for things real or imaginary, you’re doing it wrong. And if you can’t figure out their evil scheme for how this will screw us over, stop looking for one and just praise this for the baby step it is.

    But of course, some people don’t really want to see progress on their cause, since it undermines the strength of their cause and that’s all they really care about. So we have people who insist that Obamacare somehow sabotaged the pony single-payer plan we’d never have gotten, not because it’s true, but because they didn’t want our problems to get better because it denies them the self-righteousness they feed on to get through the day. And that’s all they really care about: Being part of an epic struggle that never ends. But fuck that, I’ll go with anything that works and have no use for causes beyond that. Life’s too short to be angry all the time.

  87. #87 Narad
    February 6, 2014

    It’s the people drinking a fifth of Jack or a sixpack of Bud every day that show the problem with alcohol.

    These aren’t exactly comparable amounts. A “fifth” (750 ml) of Jack Daniels is just shy of 17 standard drinks, while six Budweisers are exactly six standard drinks.

  88. #88 LindaRosaRN
    February 7, 2014

    CVS is obviously trying to bolster its image as a conscientious pharmacy and health care provider by ceasing the sales of cigarettes, which in reality will probably do little or nothing to stop smoking. (Addicts, as has been pointed out above, won’t be thwarted so easily, and may even be more resistant to stopping.) Still CVS has every right to stop selling cigarettes.

    The improved public image of CVS may, however, lend greater legitimacy to the dietary supplements and homeopathics on their shelves.

    I bristle at the assumption that skeptics would assume a self-righteous tone with CVS about CAM products. If CVS is sincere in being health conscious, they might appreciate people pointing out to them the problem with selling these other products.

  89. #89 Lurker
    February 7, 2014

    Dr. Biobrain @ 84: Fatal alcohol overdoses are frequently in the news, particularly among university students. Acute alcohol toxicity leading to respiratory failure. Getting seriously drunk kills on average 30,000 brain cells. Not a poison?

    One doesn’t hear of people dying from acute tobacco overdoses. If tobacco smoke was a poison ‘in any amount’, I should be long since dead from having put up with it in restaurants even whist sitting in the nonsmoking section. Exaggerated claims such as ‘poison in any amount,’ and ‘third-hand smoke,’ only undermine the case in the same manner as occurred with marijuana decades ago.

    The latest science on alcohol, as reported in the Beeb online, is that it is turning out to be a leading cause of cancer.

    Clearly CVS can choose what to sell and not sell, and as for candy, at least they aren’t selling ‘candy cigarettes’ (remember those?). But the societal double-standards around alcohol are surprising in view of the damage, health consequences, and innocent deaths it causes.

    I would be highly impressed with CVS’ claim to ‘wellness’ if they made a clean sweep of it (tobacco, alcohol, homeoquacky, and the specific varieties of candy that are conducive to candy-binging in children), and even more so if they treated their employees in a manner that does not produce chronic stress. But half-arsed measures only highlight the missing half of the arse.

  90. #90 Narad
    February 7, 2014

    Getting seriously drunk kills on average 30,000 brain cells. Not a poison?

    As this magic number also circulates with respect to every drink, although I dislike the response in general, that’s a big, honking “citation needed.”

  91. #91 Narad
    February 7, 2014

    ^ (Indeed, a brief skim of Pubmed reminds me that the major neurotoxic pathway proposed is withdrawal-based glutaminergic excitotoxicity.)

  92. #92 Helianthus
    February 7, 2014

    A seemingly commendable decision, but smokers do not purchase tobacco products impulsively just because they happen to see them for sale in a store.

    *sigh*
    Which part of “addiction” and “temptation” don’t you understand?
    Said by a guy who got 4 pounds back last month after stopping too many times at my local bakery for some sugar-and-fat treat.

    “impulsive purchase” may be untrue for regular consumers, but for people trying to reduce their daily mileage or quit…

  93. #93 Narad
    February 7, 2014

    at least they aren’t selling ‘candy cigarettes’

    Are they selling Smarties? Are wax teeth an invitation to poor dental hygiene? When candy cigarettes are outlawed, only outlaws will have candy cigarettes.

  94. #94 Rebecca Fisher
    February 7, 2014

    And Age of Idiocy’s take on it?

    CVS bans cigarettes, a legal product for adults whose hazards are well-advertised, to double down on medical interventions like flu shots containing hideously toxic ethyl mercury. Makes smoking look good!

    *Sigh*

  95. #95 lilady
    February 7, 2014

    @ Rebecca Fisher: Did you actually expect AoA to publish anything that has a semblance of being on-topic…minus the inane attacks on vaccines?

  96. #96 Art
    February 7, 2014

    Seeing as that they are one of the few stores to carry them as long as they don’t thwart my perverse love of NECO wafers CVS is all right by me.

  97. #97 Rebecca Fisher
    February 7, 2014

    @lilady: No, but I was quite impressed that given their repeated likening of vaccine science to “tobacco science” that they managed to come up with anything quite that half-witted.

  98. #98 Narad
    February 7, 2014

    Synchronicity alert.

    Seeing as that they are one of the few stores to carry them as long as they don’t thwart my perverse love of NECO wafers CVS is all right by me.

    “When her husband came over I had twenty or thirty Necco wafers, with a drop from the new batch on each, drying out on the coffee table in front of me but I wasn’t sure what I ought to do with them. I wanted to nibble some myself but I still believed in the “ground control” idea, and for all I knew, the 2,000-microgram woman, still an utter novice, would suddenly start tripping like crazy at 3 a.m. and need my assistance.

    “‘I guess I’ll just hand them out free to some of our most experienced people but I will have to warn them,’ I said. ‘The fact is that I don’t really know what this stuff is.’

    “‘Why don’t I try one?’ her husband suggested. I handed him a slimy pink disc, thinking he would take it later, but he popped it down without a second’s hesitation. Off they went in their Cadillac. I lit up a joint, poured a drink and turned on the stereo.

    “The phone rang. It was the 2,000-microgram woman, still straight. ‘Everything’ was ‘fine’ but she thought I ought to come over to their house. Whew. When I walked in I found her husband, wearing a bathrobe, seated in an easy chair, surrounded by his adoring family and beaming away like a lighthouse.

    “‘Ask me anything!’ he announced, making a lordly gesture. He was on one of the most beautiful, well-balanced, dignified, humorous, kind, loving, optimistic and altogether glorious trips I have ever witnessed. The man was brimming over with good cheer and happy news for one and all. His sons both had good trips in the days that followed, but their poor mother never got an inch off the ground, although she tried several times.

    “When Life’s hired scrivener asked for the name of someone to interview, I arranged a meeting for him with my favorite new Psychedelian family. His article, entitled ‘A Midwestern Businessman’s Trip,’ appeared on the first page of Life’s spread on LSD. The Neo-American Church wasn’t mentioned, so I put a curse on Life and it has since become a mere shadow of its former self.”

  99. #99 lilady
    February 7, 2014

    Since I retired eight years ago and I have a public pension…and health care/drug coverage from my State, I’ve been switched around every year or so for my drug plan. So yeah, my drug coverage (and my dependent-husband’s drug coverage), is now back at CVS-Caremark, as of January 1, 2014. My retirement system from whence comes my pittance pension and and our excellent medical/drug coverage provides a formulary of drugs covered (generic and name brand) in printed format and on the internet.

    So there you have it folks; the DH has a larger pension and a larger Social Security Check, but I have the benefits package…and I’m the brains behind our investments.

    Art…do you mean Necco wafers?

    @ Rebecca: I love the AoA contests and the chance to win a copy of one of the books they tout…or a generous supply of some crappy supplement from one of the pharmacies which buys ad space on AoA.

  100. #100 herr doktor bimler
    February 7, 2014

    Getting seriously drunk kills on average 30,000 brain cells. Not a poison?

    I for one am glad when a made-up number presents itself with some humility, as having only a single significant figure. If it came from Gary Null, or Mikey, it would be “kills on average 32,756 brain cells”.

    Does the figure include glial cells, or just neurons? Is it just for the cerebrum, or does it include the order-of-magnitude-larger number of neurons in the cerebellum? Inquiring minds are inquiring.

  101. #101 herr doktor bimler
    February 7, 2014

    Chainsaws and aardvaarks when used correctly are not detrimental to people’s health.
    I am hoping that someone will be able to advise me as to the correct use of an aardvark. Then I will be able to sleep.

  102. #102 trrll
    February 7, 2014

    Congratulations. I was actually expecting you to jump on CVS for homeopathic and other questionable nutriceuticals, but you clearly have you priorities in order. This will cost CVS money, and is the single place where CVS can take a stand in favor of health.

  103. #103 Helianthus
    February 7, 2014

    OT sideline

    @ herr doktor bimler

    I am hoping that someone will be able to advise me as to the correct use of an aardvark.

    Don’t use one to beat mice into submission. For this task, a rattlesnake is better.

    Eh, I just spent 10 minutes looking up aardvark, armadillos and pangolin – all anteaters, but quite different animals. Learning stuff is fun.
    Sadly, no sound advice on their proper use.

  104. #104 Renate
    February 7, 2014

    Aardvarks are perhaps usefull to get rid of ants or termites or as cartoon character.
    http://www.youtube.com/watch?v=t7aKgR7hcpE

  105. #105 Denice Walter
    February 7, 2014

    @ herr doktor bimler:

    Actually, the Null-macher insists that each drink kills _one million_ brain cells? And he hasn’t had a single drink in his entire life.
    As usual, what he says just doesn’t add up.**

    re Necco wafers:
    One hopes that they don’t contain real ‘neko’. That would be terrible.

    ** -btw- it appears that the tosser has been tossed from at least two Pacifica stations.

  106. #106 LW
    February 7, 2014

    If it came from Gary Null, or Mikey, it would be “kills on average 32,756 brain cells”.

    if it came from Gary Null or Mikey it would be “kills 32,767 brain cells.” Those guys give you the real number, not like some mere scientist with his averages and standard deviations.

  107. #107 Militant Agnostic
    February 7, 2014

    Alcohol, on the other hand, taken in moderation is healthier than abstaining; or so says the latest medical research.

    We may have a case of correlation not being causation. At least one study has shown this apparent benefit disappears when adjusting for people who do not drink because of health problems and for those who are non drinkers due to prior alcoholism. I suspect there is strong tendency to for studies that tell people what they want to hear to be more salient.

  108. #108 Kathryn
    February 7, 2014

    I am not fond of CVS because it always took way too long to get prescriptions filled and they always got something wrong on the first or second try: couldn’t find the prescription until my doctor faxed it over AGAIN, wouldn’t bill my insurance correctly, filled a different prescription than I wanted (refilled $UsualMed when I wanted $NewAntibiotic), so that it would take up to two hours to get a routine prescription filled. I wasn’t sure if the staff were untrained, the computer system was difficult to manage, or if they just wanted to keep me hanging out in the store to buy things while I waited.

    When I was in the market for a flu shot, I decided to try CVS because I had 40 minutes to wait for the train anyhow and CVS was on my way back to the train station. They informed me it would be 90 minutes until the pharmacist returned from lunch. (State law allows the pharmacy to close for 30 minutes for the pharmacist to take lunch.) So I went to Walgreens when I got home and got my shot there instead.

  109. #109 Kathryn
    February 7, 2014

    Sorry, left out the conclusion.

    I’m glad CVS isn’t selling cigarettes, but with such horrible service, I’m not planning to shop there unless it’s the only reasonable option.

  110. #110 Orac
    February 7, 2014

    I bristle at the assumption that skeptics would assume a self-righteous tone with CVS about CAM products. If CVS is sincere in being health conscious, they might appreciate people pointing out to them the problem with selling these other products.

    Bristle all you like. Your comment was a perfect example of exactly what I was talking about.

  111. #111 The Very Reverend Battleaxe of Knowledge
    February 7, 2014

    I could have sworn I’d been in a CVS, but I guess that was GNC—kind of a vitamin/supplement/health “food” store. Apparently there are none in Washington, although Yelp shows a couple: “CLOSED”.

  112. #112 incitatus
    February 7, 2014

    #39 Orac Im saying that whether or not a healthcare company sells cigarettes, hand grenades, buffalo or sofas is entirely value neutral. it is neither good nor bad. Good and bad only come into it if what they sell is misadvertised, miss-sold or sold under false information. If i sell someone a hand grenade and tell them its a pessary that’s bad. If i sell them a hand grenade in the full knowledge of what it is and what it does, that’s value neutral. The assumption seems to be that because a shop sells healthcare things everything in it needs to be health promoting. Why? Are we saying consumers are so stupid that because a shop sells drugs they assume everything there is a drug? If i wander into starbucks ( a shop that sells”coffee” as its main business) they also sell electrical goods, crockery, breath mints etc. Admittedly if i tried to drink one of their coffeemakers it would be bad for me but to do so would make me a moron.
    Or are we saying that being a healthcare establishment makes this place so sacred that no bad things are allowed? nothing harmful or scary, just people in crisp white coats floating on clouds of love?

  113. #113 Shay
    February 7, 2014

    I am hoping that someone will be able to advise me as to the correct use of an aardvark.

    Useful in Scrabble games but not much else, I’m afraid.

  114. #114 Gingerbaker
    February 7, 2014

    For those of you who want to argue this is a purely corporate decision:

    It is a decision applauded by Orac, and many others here, not in celebration of corporate autonomy but rather because a product you all despise will not be freely available at CVS.

    A legal product will no longer be available, but not because it is no longer profitable to sell it. Not because there are not enough people who would like to buy it at CVS. The stock actually does move off the shelves. No, this product is is disliked by the majority of people in the country. In fact, the people who use this product are disliked by the majority of people in this country. So, fuck ‘em.

    Applauding the restriction of an unpopular product, used by unpopular people based solely on a moral disapproval of that product and those people is the tyranny of the majority writ large and bold. It is the same strategy used by Republicans who can’t win a logical or moral argument against abortion, but who can, by God, make it next to impossible for poor women to actually have access to them.

    I’m sure you would all be lining up, if every retail outlet in the country mirrored the CVS decision, to protest the lack of access of smokers to cigarettes, right? Bullshit – you would no doubt be telling me that a corporation can sell or not sell whatever it wants, and you would all be happy as hell that the war against Big Tobacco was going swimmingly. After all, it’s not your ox being gored, is it?

    The motive for the CVS decision is transparent – they feel it will translate into more profit dollars for them in the long run, as they try to hype new billable services. But those of you readers who applaud the decision – what is your motive for enjoying the blatant discrimination against an addicted underclass?

    How would you feel if CVS announced it was no longer going to carry intimate products used by homosexuals, because although they would lose revenue, it would ultimately help to reduce HIV infection rates?

    One of the reasons CVS made this decision because they knew they would not face major blowback from people objecting to discrimination against smokers. And they were right.

  115. #115 Denice Walter
    February 7, 2014

    OT but are alt med loons dreaming up and writing about their complicated schemes in a protracted manner over months in order to hype new products ever TRULY OT @ RI?

    Mikey finally reveals the true purpose behind his recent posturings in his “lab”- it was all a set-up to showcase his newest supplement formula.

    “Oh no!” you say,” You must be joking!”
    No, I am totally serious.
    Mike reveals that he decided to DO something because, since Fukushima, mankind has been endangered by radiation and iodine is not enough!

    He has been creating a supplement that blocks cesium-137 from the digestive tract and has tested it in his lab – and it works! It will contain nothing from ((shudder))China and will have 5 ingredients- 4 you already recognise but the fifth will be a “rare marine botanical”. He tested “over 100 substances” to find the most effective ones that will capture the bad and carry it off.

    The world’s only ” lab-validated radiological defense supplement” will be available in April and can be pre-ordered in March. Of course, governments will rush in to scoop it up, get yours now! It’s even possible that the government will shut down is facilities- so hurry up!

    You may also become a “partner” and sell it yourself! At only 25 USD for a bottle fo 100! Get it as a gift for that special prepper, survivalist or lovely person who lives near a nuclear power plant or Fukushima! Valentine’s Day is nearly here, you know.

    MIke offers a one million dollar challenge to anyone who can demonstrate- in a lab- that it doesn’t bind with cesium-137.

  116. #116 incitatus
    February 7, 2014

    #45 “The answer is in one of the very sentences you quoted. Chainsaws and aardvaarks when used correctly are not detrimental to people’s health. Cigarettes when used as instructed ARE. CVS is in the business of HEALTH CARE therefore, it is not in keeping with their advertising message that they should sell you a product that is solidly proven to harm your health.”

    again this is silly. Its saying that a shop can only sell things for one purpose. This leads almost inexorably to shopping malls of infinite size. Actually that may explain a few things….

    But even if we accept the Aardvarks are not harmful argument ( have you seen the claws on those things?) why would this matter. If i sell someone something that is harmful to them in all circumstances, i tell them up front that it is harmfull, and i ensure that the price it is sold at covers the harm that it does ( in the uk it is arguable that the cigarette tax kinda covers the health care costs- the numbers are wonky but one can pretend its true for the sake of argument)….then what is the problem?

  117. #117 Denice Walter
    February 7, 2014

    That should be:
    over 1000 substances

  118. #118 JGC
    February 7, 2014

    Uhh…no.

    Good and bad only come into it if what they sell is misadvertised, miss-sold or sold under false information… If i sell them a hand grenade in the full knowledge of what it is and what it does, that’s value neutral.

    So if I sell them Rohypnol and tell them it’s a date-rape drug, that’s value neutral? Really?

  119. #119 Orac
    February 7, 2014

    Gingerbaker amuses me. Such Libertarian claptrap, divorced from the real world, only helps make my points for me, so self-evidently silly it is.

  120. #120 Ren
    February 7, 2014

    “How would you feel if CVS announced it was no longer going to carry intimate products used by homosexuals, because although they would lose revenue, it would ultimately help to reduce HIV infection rates?”

    That’s hilarious. Because people will not have sex without those “intimate products”? And what does that even mean?!

  121. #121 incitatus
    February 7, 2014

    #118 “So if I sell them Rohypnol and tell them it’s a date-rape drug, that’s value neutral? Really?”

    provided you told them honestly what it was and what it did, yes. Turn it around perhaps, what would be wrong with it?

  122. #122 Denice Walter
    February 7, 2014

    I would think that some “intimate products used by homosexuals” might REDUCE hiv rates.

  123. #123 AdamG
    February 7, 2014

    what is your motive for enjoying the blatant discrimination against an addicted underclass?

    Are you serious? Do you understand what the word ‘discrimination’ means?

  124. #124 Todd W.
    http://www.harpocratesspeaks.com
    February 7, 2014

    Gingerbaker strikes me as either a Libertarian smoker or a tobacco company employee.

    And incitatus seems to think that ethics should not enter into any commercial transaction or decision.

  125. #125 Orac
    February 7, 2014

    Yup, and incitatus is the more scary of the two for so completely divorcing any morality from commercial transactions or decisions. Gingerbaker just strikes me more as probably being a smoker who, because society increasingly frowns upon smoking, fancies himself a persecuted underclass, or perhaps he’s a libertarian who thinks that no restrictions whatsoever should apply to smoking or to the sale of tobacco products.

  126. #126 incitatus
    February 7, 2014

    I just think that ethics and commerce are pretty incompatible, to be honest. I also don’t equate self harm with any ethical violation. ( I dont mean self harm as in slicing oneself up per se, but lets say as a wider context such as too many cakes/ smoking/ drinking too much).

    I would have a huge problem with any cigarette manufacturer who claimed they were health giving wonder sticks, because i can see the ethical violation there. But ( and i am not saying this is the case, but lets say it is) if a fag manufacturer is telling the customer exactly what the product will do to them in all their gory detail then its up to the customer if they want to smoke the stinky death weed. For me there the manufacturer has done nothing ethically wrong.

  127. #127 Todd W.
    http://www.harpocratesspeaks.com
    February 7, 2014

    @Orac

    For some reason, this skit came to mind.

  128. #128 Lumen
    February 7, 2014

    “again this is silly. Its saying that a shop can only sell things for one purpose.”

    Not at all silly. You seem to be trapped in some sort of general store mindset that insists that the free market is in no way connected to specialization, marketing or public perception.

    CVS has made a decision about how they want to make money. They want to be perceived as a health care center. That is a specific market, and indeed if my own neighborhood is any indicator it is a reasonable place for them to reposition to, since my local CVS competes with no less than three 7-11 stores as well as some small mom and pop corner stores.

    It would seem that they believe that selling tobacco undercuts that marketing goal. I would generally agree, since the general appearance of CVS as a crappy grocery has in the past prevented me from taking them seriously as a health clinic.

    I think many of the libertarian commenters on this topic keep conflating public perception and corporate goals. So I will try to spell this out one more time. Many people (including Orac) like this decision because of moral/ethical reasons. However CVS is likely making this decision not because their own decision makers have a moral issue with it (though they may it’s not possible to tell) but because they understand that there is a public perception issue and by adjusting corporate behavior they will further strengthen their marketing image of a health care center in their customers minds. They want people to perceive that CVS is a health care center that cares about it’s customers health.

    I realize that such things as customer perception, marketing, business models and corporate identity are a bit too complicated for certain brands of popular libertarianism, but I assure you that CVSs behavior is entirely in keeping with the principles of the free market.

  129. #129 Krebiozen
    February 7, 2014

    Todd W.,
    It’s like a prequel of the Hobbit where Bilbo worked Saturdays in the Hobbiton hardware shop.

  130. #130 incitatus
    February 7, 2014

    #128 I have made no statement about the free market. It is after all at best a fiction, at worst an illusion and generally simply an excuse. And I really couldn’t care less whether their actions comply with this fictional free market or not….even so far as it exists the free market is simply one of a number of imperfect and inefficient social models. But what you are saying just highlights my worst fears about either the processing ability of the consumer, or, more likely, the corporate opinion of the processing ability of the consumer.
    In general branding, brand positioning, corporate identity, all of those things are ideas invented by marketing companies in order to keep other marketing companies in business. They only have importance because the companies who have already paid money for them say they have importance, because it would be embarrassing if they threw money down the drain, wouldn’t it..
    But to repeat I don’t really care if the store has made the decision because the pixies told them to. My main point was that I don’t understand how good or bad would come into this decision in any way, unless you were a shareholder.
    I am becoming increasingly confused as to what CVS is however. I gained the impression from earlier posts that it was essentially a pharmacy chain. Now you are using terms like healthcare centre and healthcare clinic which is puzzling. So you may have to explain what this establishment does?
    Because a pharmacy is to a health care clinic what a pedalo is to an aircraft carrier. Pharmacists like to think of themselves as healthcare professionals but they are the bit part players of the act. they are there in the background mugging away but the actual action is a long way from them. If you could train a bonobo to make sympathetic noises, read a script and count to 28 you could replace the whole profession.
    So what are CVS? pharmacy or something else?

  131. #131 AdamG
    February 7, 2014

    If you could train a bonobo to make sympathetic noises, read a script and count to 28 you could replace the whole profession.

    Wow. Do you actually know any pharmacists?

  132. #132 incitatus
    February 7, 2014

    #131 I taught pharmacy for 8 years.

  133. #133 herr doktor bimler
    February 7, 2014

    A legal product will no longer be available, but not because it is no longer profitable to sell it.

    “No longer available? One pharmacy chain is the only place selling cigarettes? Gingerbaker seems to be telling us that because cigarettes are legal, CVS has an obligation to go on selling them, because FREEDOM. Please tell me that this is a parody of the absurd mental contortions and surrealist logic through which libertarians put themselves.

    My experience of US pharmacies is restricted to a Walgreens in San Francisco, where I was impressed by the number of shelves laden with fried sugar foodstuffs in all possible permutations, and the close proximity of the sign offering free diabetes tests.

  134. #134 herr doktor bimler
    February 7, 2014

    what is your motive for enjoying the blatant discrimination against an addicted underclass?

    The question is incoherent. Enjoyment is a motive. Gingerbaker is asking “What is your motive for having a motive”?

  135. #135 incitatus
    February 7, 2014

    #134 well you have to admit that that is quite a deep philosophical discussion

  136. #136 Todd W.
    http://www.harpocratesspeaks.com
    February 7, 2014

    @incitatus

    CVS has started providing what they call “Minute Clinics”. They have RNs on staff that can handle minor health complaints, administer vaccines, etc. This is in addition to the pharmacists on staff providing prescription medications and answering questions about those medications (among other things).

    They also happen to sell convenience store type stuff (snack foods, basic household products, etc.). They are working toward an emphasis on their provision of health care through their Minute Clinics.

  137. #137 Lumen
    February 7, 2014

    #130 –

    I’m not sure where you’re from (United States or somewhere else,) so I’ll just over explain a bit and let you ignore what you already are aware of.
    CVS is what I grew up referring to as a “drugstore” which is a bit more than a “pharmacy”. In the states these chains morphed from a place to fill prescriptions and maybe buy a greeting card, to convenience store/groceries at some point, where the actual pharmacy was hidden away in the back and the rest of the store was over run with products that are completely unrelated to health care. The quality of the food varies but largely consists of items with a long shelf life, which basically means processed foods. Lots of snacks, soda pop, frozen foods etc. Walgreens is another example of this style of “pharmacy”, if you are familiar with that chain.

    Lately though CVS has been adjusting it’s offerings. It’s opened something called a “Minute Clinic” that is staffed with Nurse Practitioners and Medical assistants and is open evenings and weekends and requires no appointments. It’s also started promoting itself as a convenient place to get your flu shot, and apparently adult boosters (I just found out). This is all before the announcement that they are not going to carry tobacco products anymore.

    I think puts it into a broader context. My guess is they aren’t really happy competing with all the other stores that offer nearly identical products. Probably there just isn’t room to expand in that market.

    So when I say they are trying to become a health care center, I mean just that. They are changing their business model, to something that is actually rather rare in the States. A kind of stop in clinic with late hours and weekends for the working class. And I would also point out that the roll out of the Affordable Care Act (ObamaCare) is currently creating a pretty large number of potential customers who don’t yet have doctors, and are probably working class, so a nights and weekend clinic down the road might be very attractive to them.

  138. #138 incitatus
    February 7, 2014

    I see. Im from the UK but currently work in Switzerland. In the UK pharmacies offer vaccinations as well and the pharmacist is able to prescribe a limited number of remedies and give advice for minor ailments. Most pharmacies have consulting rooms ( normally only used for chats about missed contraceptives) and are often incorporated into larger stores. Tesco, for example, has a very large chain of pharmacies which operate inside their supermarkets.
    The idea of operating nurse practitioners from them is interesting but not far away from the UK model. Even with that though i stand by the above re pharmacists. you could replace 95% of them with a vending machine.
    But even with the idea of running a clinic within the same store i really don’t get why that’s exclusive? After all Tesco as above also sell booze, fags and often do shoe repairs. does it suggest these things are going to turn into hospitals? beep, next hernia please?

  139. #139 Kochanski
    February 7, 2014

    Excellent post ORAC. I was most pleased when I heard that CVS was going to stop selling tobacco products. It is a positive step and we should applaud them for it.

    As for Skepchick, I gave up long ago seeing them a useful skeptical source.

    I would like to share my own smoking story. I am not a smoker and never was, my mother however is. Back when I got my driver’s license and when I was old enough to purchase cigarettes, I told her that I would happily run errands for her for anything BUT her cigarettes. She had no problem with my taking that stand.

  140. #140 Narad
    February 7, 2014

    CVS has made a decision about how they want to make money. They want to be perceived as a health care center. That is a specific market, and indeed if my own neighborhood is any indicator it is a reasonable place for them to reposition to, since my local CVS competes with no less than three 7-11 stores as well as some small mom and pop corner stores.

    It would seem that they believe that selling tobacco undercuts that marketing goal. I would generally agree, since the general appearance of CVS as a crappy grocery has in the past prevented me from taking them seriously as a health clinic.

    Um, has CVS suddenly stopped being a crappy grocery store? Their stores are physically designed around this model.

    As for the “MinuteClinics,” Walgreens does the same thing, in nearly as many states, with their “Healthcare Clinics,” which are open 12 hours on weekdays and accept Medicaid in my area. I don’t really find this to be a convincing rationale for the dropping of tobacco sales – the clinics, as far as I can tell, are located in the back of the store, by the pharmacy, which has its own point-of-sale equipment. There’s no need to even see the cigarettes.

    As a brief marketing splash, sure. In the long term, though, I still think it fits nicely with the drive to eliminate cashiers in their entirety.

  141. #141 Narad
    February 7, 2014

    ^ (As a side note, I wouldn’t use either as a pharmacy. Walgreens once tried to charge me $750 for, IIRC, a month’s supply of 100 mg doxycycline (dental) after a 45-minute wait. The local independent, who offers free delivery and has effectively no wait, charged less than $100. And yet he’s the one who’s had to install a lottery terminal.)

  142. #142 sid offit
    February 8, 2014

    Bye, bye CVS. Do-goodism and business don’t mix. Are they still selling beer and soda by the way?

  143. #143 Narad
    February 8, 2014

    Bye, bye CVS. Do-goodism and business don’t mix.

    I’m sure your profound business experience, which doesn’t even include a Web presence for your “company,” will immediately be noticed in boardrooms everywhere.

    Meanwhile, you’ve probably got some more “do-gooders” to boycott. Snap to, bullethead.

    Are they still selling beer and soda by the way?

    Thanks for highlighting the fact that you yet again merely dropped by to make an ass of yourself.

  144. #144 Lawrence
    February 8, 2014

    @sid – but they are a private business and can decide to do whatever they want, right? If they decide not to sell tobacco products, seems to me that is their right and you should be applauding them…..

  145. #145 Mephistopheles O'Brien
    February 8, 2014

    @Gingerbaker

    It is a decision applauded by Orac, and many others here, not in celebration of corporate autonomy but rather because a product you all despise will not be freely available at CVS.

    This is correct except for the term “freely”, as tobacco products at CVS were never free.

    In fact, the people who use this product are disliked by the majority of people in this country.

    I don’t believe this to be true. I’m sure there’s a vocal minority who actively dislike smokers for a variety of reasons (e.g. they are weak willed addicts who whine all the time about how they should be able to smoke wherever and whenever they want”), but the majority dislike smoking and the use of other tobacco products, not the people who use them. And there are plenty of good reasons to dislike the act of using tobacco, as it can lead to:
    - cancer
    - lung disease
    - heart disease
    - causing fires
    - littering
    - stinking up the clothes, hair, and skin of people around them
    - causing the people around them to have general discomfort

    Applauding the restriction of an unpopular product, used by unpopular people based solely on a moral disapproval of that product and those people is the tyranny of the majority writ large and bold.

    Since when is applauding tyranny? Since when is expressing an opinion tyranny? Did the majority pass laws that forbade CVS from selling tobacco products? It did not. In what way is this tyrannical?

    I’m sure you would all be lining up, if every retail outlet in the country mirrored the CVS decision, to protest the lack of access of smokers to cigarettes, right?

    Nope. I certainly wouldn’t. I don’t expect that to happen, as I expect that when one vendor stops selling these products others will pick up the business. However, if it did I see it as no different from every store deciding not to stock Post Shredded Wheat Original Spoon Size (something my local grocer doesn’t stock, even though they do stock Post Shredded Wheat Spoon Size Honey Nut) or Vernors.

    After all, it’s not your ox being gored, is it?

    I’ve never owned an ox, nor gored one.

    But those of you readers who applaud the decision – what is your motive for enjoying the blatant discrimination against an addicted underclass?

    It’s something of a stretch to say that deciding not to sell a set of products is discrimination. I went to a Sonic Drive-In the other night – there wasn’t a single cigarette on the menu, and the snuff selection was appallingly small. I also didn’t find any heroin or cocaine. Should I have been outraged that addicted underclasses were being discriminated against at the take-out window?

    How would you feel if CVS announced it was no longer going to carry intimate products used by homosexuals, because although they would lose revenue, it would ultimately help to reduce HIV infection rates?

    I’d be curious what those products are, as I’ve never seen the “intimate products/homosexual” section at a CVS. I’m sure that others would be upset by the implication that homosexual sex in some way spreads HIV more effectively than heterosexual sex.

    One of the reasons CVS made this decision because they knew they would not face major blowback from people objecting to discrimination against smokers.

    So CVS’s decision to stop selling tobacco is equivalent to, say, segregated lunch counters? Regardless, I wouldn’t expect any chain store to act in a way that would create substantial hard feelings for a majority of their customers. Sometimes there is a large enough moral, social, or health issue that a store might choose to do that, but this doesn’t look like that kind of issue.

    The situation might be different in the case of a vendor with a local monopoly on a product who then refused to sell that product. An example might be if a pharmacist with a local monopoly on, say, birth control or “morning after” pills were to decide not to sell them. This would be an abuse of monopoly power (in my opinion) in an attempt to impose a moral belief on others. As mentioned above, though, I don’t perceive the two to be equivalent given the current marketplace.

  146. #146 Mephistopheles O'Brien
    February 8, 2014

    incitatus asks what would be wrong with a drug store selling Rohypnol, as long as the store specifically spelled out that this was a date rape drug. From a truth in advertising basis, nothing. Just like if you were to sell a hand grenade with a big label that said “if you release the handle, 99% of the time this will explode after a delay of 4.0 to 5.5 seconds. This will cause severe injury or death to people and property in a radius of 20 feet.” it would be perfectly truthful.

    The person who bought the Rohypnol and the used it as a date rape drug would be a felon. One might reasonably argue that the person who sold him the Rohypnol would be aiding and abetting, considering that it is not an approved drug available for medical use in the United States. I understand it is available by prescription in the UK, so if sold as a date rape drug without a prescription that would be illegal.

  147. #147 Jon H
    February 8, 2014

    I’ll give CVS one thing: They don’t sell colloidal silver products, while Walgreens does, at least on their website.

    Not only that, but at the health information part of CVS.com, content provided by EBSCO, they have a page for colloidal silver, which includes this information:
    http://health.cvs.com/GetContent.aspx?token=f75979d3-9c7c-4b16-af56-3e122a3f19e3&chunkiid=111807

    Oral colloidal silver is widely promoted on the Internet and elsewhere as a treatment for hundreds of conditions. Unfortunately, there is no evidence that this form of silver provides any medical benefits, and it can lead to an unsightly and permanent discoloration of the skin called argyria.

  148. #148 Krebiozen
    February 8, 2014

    incitatus,

    If you could train a bonobo to make sympathetic noises, read a script and count to 28 you could replace the whole profession. [...] I taught pharmacy for 8 years. [...] Even with that though i stand by the above re pharmacists. you could replace 95% of them with a vending machine.

    Personally I would prefer those who dispense controlled drugs and medical advice to have some training and have to pass some exams. A 4 year accredited course and training on the job for a year before taking the registration exam and becoming state registered sounds about right to me.

    My pharmacist has spotted contraindicated drug combinations on more than one occasion, and once treated me for an acute asthma attack. I doubt either a bonobo or a vending machine could have managed that.

    Perhaps replacing some of those who ‘teach pharmacy’ with bonobos would make more sense.

  149. #149 herr doktor bimler
    February 8, 2014

    what would be wrong with a drug store selling Rohypnol, as long as the store specifically spelled out that this was a date rape drug.

    To be fair, the dominant date-rape drug is plain old alcohol, which many bars have few qualms in selling for that purpose.

  150. #150 Politicalguineapig
    February 8, 2014

    M’OB: The person who bought the Rohypnol and the used it as a date rape drug would be a felon.

    Sadly, no. Missouri, Montana and Ohio don’t even prosecute rape anymore.

  151. #151 Shay
    February 9, 2014

    Even if that statement were true – which it isn’t – that would still leave 47 other states and the District of Columbia where the felony applied.

  152. #152 Politicalguineapig
    February 9, 2014

    Mm..I’m not sure about Texas and North Dakota.

  153. #153 Khani
    February 9, 2014

    Rape is prosecuted in North Dakota.

  154. #154 Shay
    February 9, 2014

    And in Texas.

  155. #155 Mephistopheles O'Brien
    February 9, 2014

    @Politicalguineapig – I know you’re speaking in both gross generalities and deliberate hyperbole and that you do that because you have decided to classify everyone into huge categories to make it easier to deal with (or in many cases, refuse to deal with) people.

    However, saying deliberate falsehoods which are easily disproven to malign the people of Missouri, Montana, North Dakota, Ohio, and Texas isn’t helpful or particularly amusing.

  156. #156 incitatus
    February 9, 2014

    #148 Krebiozen, i trust you have changed your doctor. However any reasonably programmed vending machine would have detected the med conflict also. The first aid is a useful plus but then first aid can be got many places.
    If you want specifics I taught analytical and organic chemistry and physical pharmacodynamics (dissolution, Log D that sort of thing) in the second oldest school of pharmacy in the UK. It was a constant battle to get the students to apply any sort of rigor to thier work, and the scientific elements were constantly deprecated by both the students and the registered pharmacists on the staff who felt that a knowledge of soft customer skills was far more important than any understanding of how drugs work, are taken up, are metabolised or are eliminated. This experience has led me to an ingrained habit of checking any prescription i get dispensed item by item and pill by pill because I do not trust the basic maths skills of those dispensing.
    An unfortunate experience perhaps. N=1 ( well i am 1, the number of pharmacists to whose training i contributed would be closer to 1500. Well thats a rounded up value for those who graduated, they had to do pre reg after that) perhaps.
    But in these days of prepackaged medication(in the uk and EU pills arrive in blister packs, pre packed into 28. A bottle of loose pills is a very very rare sight), computerised drug databases and customer records the plain fact is that the average pharmacist is someone who runs a corner store with a lot of CAM in it, can read instructions and package meds. Most of the advice is read off a script ( “have you had this medication before? Do not operate heavy machinery or drive any princesses whilst taking this”) and i have a nice voice on my smartphone that could do that.
    perhaps 2% of uk pharmacists work in a hospital situation where they are required to play an active role in customer care, where the drug regimes are challenging to formulate to minimise patient harm. Thinking sensibly i have long thought there should be two types of pharmacist. actual pharmacists and a lesser breed for the count to 28 side.

    I am aware my dislike and disappointment has come across but i have rarely been so disillusioned with a whole profession. And most of that was caused by the teacher practitioners. In contrast the medics i have taught and worked with have been generally far far more optimism inspiring. I tend to encounter them either right at the start ( i think you would call it pre med) or at the research end ( point of care diagnostics is in my line) but there the outcome is much more positive.

  157. #157 Heina
    February 10, 2014

    Interesting. I’m putting up a response tomorrow.

  158. #158 DLC
    February 10, 2014

    Orac : I agree. CVS is doing something worth doing, and should be congratulated for it. We can go back to complaining about the homeopathic junk tomorrow.

    So, Libertarians, if I sell candy-flavored cyanide, properly labelled, that’s fine with you ? If I put it on the shelf next to the whoppers and NECCO wafers that’d be just peachy ?

  159. #159 Narad
    February 10, 2014

    But in these days of prepackaged medication(in the uk and EU pills arrive in blister packs, pre packed into 28. A bottle of loose pills is a very very rare sight)

    It’s the other way around in the U.S., from my experience. My local independent occasionally will offer to give me the last of his supply of something and complete filling the prescription the next day if it’s something he doesn’t turn over frequently enough to keep a large stock of.

    The hypothetical vending machine would have to be very large and able to phone insurance companies (mine recently changed their billing system, which gave me a scare that something was no longer covered) and answer my questions about how long it is until a refill would be covered and whether there are less expensive alternatives to certain medications, be willing to call up physicians, offer delivery in inclement weather, and so forth.

  160. #160 incitatus
    February 12, 2014

    #158 selling candy flavoured cyanide yes. however the placement on the shelf you would have to be careful that people didnt accidentally pick it up. Because that would be unethical

    Narad, there you are dropping into the insanity which is the american healthcare system which i really dont understand. The UK is slightly special but it wouldnt work like that in switzerland or france either. You lot seem to have to work quite hard at being a patient….

  161. #161 Aquilus Domini
    Jackson, MI
    February 17, 2014

    Loved the post, proved a bunch of points about how obnoxious people can be even when good things happen. I’m quite pleased, personally, that CVS did away with tobacco products, this might be the beginning of the end of the tobacco industry, which would really be fantastic. If people can’t buy them anymore, they won’t get sick from the diseases they cause then they become less of a drain on the system. My sister smokes like a chimney and refuses to quit. She’s tried quitting but always she goes back. What’s worse is that she smokes around her kids and has since they were born. I worry about them getting cancers. But anyway, i’m glad to see a positive review of CVS’s decision. Those “i have a right to smoke” people are self-loving jerks, that smoke causes pollution and hurts other humans and animals, so no, they don’t have a “right” to smoke because it infringes on the rights of others that wish to live smoke free.

  162. #162 Aquilus Domini
    Jackson, MI
    February 17, 2014

    Loved the post, proved a bunch of points about how obnoxious people can be even when good things happen. I’m quite pleased, personally, that CVS did away with tobacco products, this might be the beginning of the end of the tobacco industry, which would really be fantastic. If people can’t buy them anymore, they won’t get sick from the diseases they cause then they become less of a drain on the system. My sister smokes like a chimney and refuses to quit. She’s tried quitting but always she goes back. What’s worse is that she smokes around her kids and has since they were born. I worry about them getting cancers. But anyway, i’m glad to see a positive review of CVS’s decision. Those “i have a right to smoke” people are self-loving jerks, that smoke causes pollution and hurts other humans and animals, so no, they don’t have a “right” to smoke because it infringes on the rights of others that wish to live smoke free.

  163. #163 Aquilus Domini
    Jackson, MI
    February 17, 2014

    Loved the post, proved a bunch of points about how obnoxious people can be even when good things happen. I’m quite pleased, personally, that CVS did away with tobacco products, this might be the beginning of the end of the tobacco industry, which would really be fantastic. If people can’t buy them anymore, they won’t get sick from the diseases they cause then they become less of a drain on the system. My sister smokes like a chimney and refuses to quit. She’s tried quitting but always she goes back. What’s worse is that she smokes around her kids and has since they were born. I worry about them getting cancers. But anyway, i’m glad to see a positive review of CVS’s decision. Those “i have a right to smoke” people are self-loving jerks, that smoke causes pollution and hurts other humans and animals, so no, they don’t have a “right” to smoke because it infringes on the rights of others that wish to live smoke free.

  164. #164 AnnB
    March 8, 2014

    I have to look more into the loss of profits. Business with rare exceptions does every single thing for money or not to lose money. I know from working in a pharmacy that selling cigarettes is very labor intensive and it may just be that it is no longer cost-effective for them to sell them. And they most certainly would pretend that removing them is altruistic.

  165. #165 Narad
    March 9, 2014

    I know from working in a pharmacy that selling cigarettes is very labor intensive and it may just be that it is no longer cost-effective for them to sell them.

    It’s not especially labor-intensive if the cigarettes are sitting immediately behind the checkers. This is why I pointed out above that CVS locally appears to be trying to get rid of these pesky employees in the first place.