(Reuters) CVS Caremark Corp will stop selling tobacco products at its 7,600 stores by October 1, the company said on Wednesday, making it the first national drugstore chain in the United States to take cigarettes off the shelves.

Public health experts hailed the precedent setting decision by the No. 2 U.S. drugstore as a step that could pressure other retailers to follow suit. With pharmacies taking on a larger role in the U.S. healthcare system with walk in clinics and services such as managing health plans, many experts say they should no longer offer unhealthy products like tobacco.

President Barack Obama, a former smoker, praised CVS, saying in a statement the move will help wider efforts to “reduce tobacco related deaths, cancer, and heart disease, as well as bring down healthcare costs.”

CVS expects the decision to hurt profits initially, along with a $2 billion hit to annual sales. But the company, whose Caremark unit is a pharmacy benefits manager for corporations and the U.S. government’s Medicare program, believes the move will boost its appeal as a healthcare provider.

CVS hopes to replace some sales through signing up customers to smoking cessation programs, which will be a selling point with potential corporate contracts.

Analysts said CVS could eventually recoup lost sales through increased use of its healthcare services. But investors focused on the short term pain. CVS shares fell 1 percent. Larger rival Walgreen Co, which will keep selling cigarettes, rose 3.9 percent, while No. 3 Rite Aid Corp which also will still offer cigarettes rose 2 percent.

Shares of cigarette makers Lorillard Inc, Altria Group and Reynolds American all slipped.

Pharmacists have long been a source of community health information, and drugstore chains have embraced that tradition by adding walk in clinics. CVS is the largest U.S. pharmacy healthcare provider, with more than 800 MinuteClinic locations.

“I think CVS recognized that it was just paradoxical to be both a seller of deadly products and a healthcare provider,” U.S. Centers for Disease Control and Prevention Director Thomas Frieden told Reuters.

CVS Caremark Chief Medical Officer Dr. Troyen Brennan said in a piece in the Journal of the American Medical Association that increased health coverage under the U.S. Affordable Care Act “comes with a price” of promoting public health.

Experts noted that healthcare organizations and advocacy groups such as Americans for Nonsmokers’ Rights have been urging pharmacies for years to get out of the tobacco business.

Cornell University communication professor Jeff Niederdeppe cited “an evolving social climate that has become less and less supportive of the marketing, sale, and use of tobacco products in the U.S.”

Some U.S. cities, including Boston and San Francisco, already ban the sale of tobacco products in pharmacies, and nonsmoking advocates hope other chains will follow CVS.

“This is a trend we’re going to see many, many retailers and food companies jump on,” said Alexandra von Plato, president and global chief creative officer of Publicis Healthcare Communications Group.

Only 18 percent of U.S. adults smoke, down sharply from 43 percent in 1965. But the habit still kills 480,000 Americans each year, remaining the leading cause of preventable death in the United States.

SHORT TERM HIT

CVS said the decision to drop tobacco sales will cost the company 6 cents to 9 cents in profit per share this year. Analysts expect 2014 revenue of $132.9 billion and earnings of $4.47 per share, according to Thomson Reuters I/B/E/S.

Overall U.S. cigarette sales fell 31.3 percent from 2003 to 2013, according to Euromonitor International. And CVS faced more competition in selling to that shrinking market, as discount retailers Family Dollar Stores Inc and Dollar General Corp chains charge much less and have far more locations.

“We believe the move will be viewed as a positive long term decision by CVS, despite the near term profit drag, as it paves the way for increased credibility with both healthcare consumers and payers,” ISI Group analyst Ross Muken wrote in a note to investors.

CVS has been bolstering its position in the healthcare market in recent months and in December, it said it expected pharmacy benefit manager revenue to rise between 7.25 percent and 8.5 percent in 2014, more than double the rate of retail business growth.

Tobacco companies shrugged off the announcement even as shares dipped on concerns about potential disruption to sales.

“It’s up to retailers to decide if they’re going to sell tobacco products,” said Brian May, spokesman for Altria Group, maker of Marlboro and other popular brands.

RBC Capital Markets analyst Nik Modi said he expected little impact on tobacco companies. He noted that they rely on convenience stores for more than 75 percent of sales.

But Dr. Richard Wender of the American Cancer Society said CVS’s move would have an effect.

“Every time we make it more difficult to purchase a pack of cigarettes, someone quits.”

(Reporting by Phil Wahba in New York and Julie Steenhuysen in Chicago Editing by Jilian Mincer, Lisa Shumaker and David Gregorio)

E-cigarettes: separating fiction from fact

Brands of menthol cigarettes in new zealand

By Serena Gordon
HealthDay Reporter

FRIDAY, Jan. 3, 2014 (HealthDay News) It’s the new year, a time when a smokers’ thoughts often turn to quitting.

Some people may use that promise of a fresh start to trade their tobacco cigarettes for an electronic cigarette, a device that attempts to mimic the look and feel of a cigarette and often contains nicotine.

Here’s what you need to know about e cigarettes

What is an e cigarette?

The U.S. Food and Drug Administration (FDA) describes an e cigarette as a battery operated device that turns nicotine, flavorings and other chemicals into a vapor that can be inhaled. The ones that contain nicotine offer varying concentrations of nicotine. Most are designed to look like a tobacco cigarette, but some look like everyday objects, such as pens or USB drives, according to the FDA.

How does an e cigarette work?

“Nicotine or flavorings are dissolved into propylene glycol usually, though it’s hard to know for sure because they’re not regulated,” explained smoking cessation expert Dr. Gordon Strauss, founder of QuitGroups and a psychiatrist at Lenox Hill Hospital in New York City. “Then, when heated, you can inhale the vapor.”

The process of using an e cigarette is called “vaping” rather than smoking, according to Hilary Tindle, an assistant professor of medicine and director of the tobacco treatment service at the University of Pittsburgh Medical Center. She said that people who use electronic cigarettes are called “vapers” rather than smokers.

Although many e cigarettes are designed to look like regular cigarettes, both Tindle and Strauss said they don’t exactly replicate the smoking experience, particularly when it comes to the nicotine delivery. Most of the nicotine in e cigarettes gets into the bloodstream through the soft tissue of your cheeks (buccal mucosa) instead of through your lungs, like it does with a tobacco cigarette.

“Nicotine from a regular cigarette gets to the brain much quicker, which may make them more addictive and satisfying,” Strauss said.

Where can e cigarettes be used?

“People want to use e cigarettes anywhere they can’t smoke,” Strauss said. “I sat next to someone on a plane who was using an e cigarette. He was using it to get nicotine during the flight.” But he noted that just where it’s OK to use an e cigarette indoors, for instance? remains unclear.

Wherever they’re used, though, he said it’s unlikely that anyone would get more than a miniscule amount of nicotine secondhand from an e cigarette.

Can an e cigarette help people quit smoking?

That, too, seems to be an unanswered question. Tindle said that “it’s too early to tell definitively that e cigarettes can help people quit.”

A study published in The Lancet in September was the first moderately sized, randomized and controlled trial of the use of e cigarettes to quit smoking, she said. It compared nicotine containing e cigarettes to nicotine patches and to e cigarettes that simply contained flavorings. The researchers found essentially no differences in the quit rates for the products after six months of use.

“E cigarettes didn’t do worse than the patch, and there were no differences in the adverse events,” she said. “I would be happy if it turned out to be a safe and effective alternative for quitting, but we need a few more large trials for safety and efficacy.”

Strauss noted that “although we can’t say with certainty that e cigarettes are an effective way to quit, people are using them” for that purpose. “Some people have told me that e cigarettes are like a godsend,” he said.

Former smoker Elizabeth Phillips would agree. She’s been smoke free since July 2012 with the help of e cigarettes, which she used for about eight months after giving up tobacco cigarettes.

“E cigarettes allowed me to gradually quit smoking without completely removing myself from the physical actions and social experience associated with smoking,” Phillips said. “I consider my e cigarette experience as a baby step that changed my life.”

Are e cigarettes approved or regulated by the government?

E cigarettes are not currently regulated in a specific way by the FDA. The agency would like to change this, however, and last April filed a request for the authority to regulate e cigarettes as a tobacco product.

The attorneys general of 40 states agree that electronic cigarettes should be regulated and sent a letter to the FDA in September requesting oversight of the products. They contend that e cigarettes are being marketed to children some brands have fruit and candy flavors or are advertising with cartoon characters. And, they note that the health effects of e cigarettes have not been well studied, especially in children.

Are e cigarettes dangerous?

“It’s not the nicotine in cigarettes that kills you, and the nicotine in e cigarettes probably won’t really hurt you either, but again, it hasn’t been studied,” Strauss said. “Is smoking something out of a metal and plastic container safer than a cigarette? Cigarettes are already so bad for you it’s hard to imagine anything worse. But, it’s a risk/benefit analysis. For a parent trying to quit, we know that secondhand smoke is a huge risk to kids, so if an electronic cigarette keeps you from smoking, maybe you’d be helping kids with asthma or saving babies.”

But on the flip side, he said, in former smokers, using an e cigarette could trigger the urge to smoke again.

The other big concern is children using e cigarettes.

“More and more middle and high school kids are using e cigarettes,” Tindle said. “Some are smoking conventional cigarettes, too. The latest data from the CDC found the rate of teens reporting ever having used an e cigarette doubled in just a year. We could be creating new nicotine addicts. We don’t know what the addictive properties of e cigarettes are,” she added.

“It’s shocking that they’ve been allowed to sell to minors,” Tindle said.

More information

The U.S. Food and Drug Administration has more about electronic cigarettes.

This HealthDay story describes options to help you quit smoking.

SOURCES Hilary Tindle, M.D., assistant professor of medicine, and director, Tobacco Treatment Service, University of Pittsburgh Medical Center, Pittsburgh Gordon Strauss, M.D., psychiatrist, Lenox Hill Hospital, and founder, QuitGroups, New York City Elizabeth Phillips, Philadelphia Sept. 9, 2013, The Lancet, online

Last Updated Jan 3, 2014

Health News Copyright &#169 2014 HealthDay. All rights reserved.