By Linda Carroll
(Reuters Health) – Over the past six years, several U.S. chain pharmacies have been caught numerous times by the Food and Drug Administration selling tobacco products to minors, a new study finds.
The biggest offender: Walgreens, according to the report published in JAMA Pediatrics.
Between 2012 and 2017, Walgreens was caught selling tobacco products to minors 1,296 times, representing about once in every 10 inspections.
During inspections, an adult undercover inspector goes into the store with a minor, who then tries to purchase tobacco products, explained the study’s lead author, Joseph Lee, an assistant professor of health education and promotion at East Carolina University in Greenville, North Carolina.
“If the product is sold to the minor, then nothing happens right away,” Lee said. “If tobacco products are sold, then a warning letter is sent by the FDA.” Things can escalate after that if the company continues to break the law, Lee said. There can be big fines and eventually the company can be banned from selling tobacco altogether.
Lee suspects that the numbers provided by the FDA inspection records underestimate how many times chain pharmacies have actually made tobacco sales to minors.
Arnold Levinson of the Colorado School of Public Health in Aurora, who wasn’t involved in the research, agrees that the problem is probably bigger than the FDA numbers suggest.
“The FDA data are the best we have available, but they only measure how often the pharmacies got caught selling tobacco to minors during undercover enforcement tests,” Levinson said in an email. “The problem is much bigger than these results suggest. If pharmacies are serious about being in the health business, they need to stop selling this deadly product – and not just to kids.”
While Walgreens was racking up a total of 1,296 violations during 12,587 inspections (a rate of 10.3 percent), Rite Aid was caught 314 times during 7,483 inspections (a rate of 4.2 percent), and other chains were caught 51 out of 667 inspections (a rate of 7.6 percent). CVS, which stopped selling tobacco products altogether in September 2014, was caught 172 times in 3,126 inspections (a rate of 5.5 percent).
A Walgreens spokesman told Reuters Health in an emailed statement, “The health and wellbeing of our customers is our top priority and core mission. We take this matter very seriously and have taken a number of steps over the past several years to help address the important issue of tobacco sales to minors. To further strengthen our practices, going forward, we will be requiring identification for anyone purchasing tobacco products regardless of age in all of our stores nationwide by early October. As part of this measure, we also will be training all our store team members on the new requirements and install signs in our stores to help explain the change to our customers.”
While the numbers from the FDA may be an underestimate, the comparison between companies is probably accurate, Lee noted.
Why the focus on pharmacies?
“What concerns me about pharmacies selling tobacco in the first place is the horrible irony of their selling these products to minors,” Lee said. “Secondly, pharmacies tend to have slightly cheaper prices, which is worrisome because youth are particularly sensitive to prices and are always looking for places that are more affordable.”
Things may be changing, Lee said. “There’s a big move nationally to stop pharmacies from selling tobacco products. You shouldn’t be able to buy cigarettes at the same time as you’re buying drugs to treat tobacco-related disease.”
“The study strengthens the case even further for banning sales in pharmacies,” said Daniel Giovenco of Columbia University’s Mailman School of Public Health in New York, who wasn’t involved in the study. “It shows that chain pharmacies often violate the law against selling tobacco to minors.”
Giovenco has studied the impact of New York City’s law banning tobacco sales in pharmacies and found that the legislation helped reduce the “density” of retail stores where tobacco could be purchased.
It makes sense to start with pharmacies, Giovenco added. “They are centers of health and wellness,” he explained. “So they shouldn’t be selling the most dangerous consumer product on the market.”
SOURCE: https://bit.ly/2Nfd2dO JAMA Pediatrics, online September 4, 2018.