Consumers buy fewer cigarettes after CVS stops selling them

After CVS, the large retail pharmacy chain, stopped selling cigarettes in its stores, many consumers who used to buy their smokes at CVS simply bought fewer cigarettes and presumably smoked less.

Investigators used households’ purchasing data to assess how many of almost 9000 households stopped purchasing cigarettes for at least 6 months from September 2014-when CVS removed tobacco products from its stores-to August 2015. Participants were divided into 3 groups: those who purchased cigarettes exclusively at CVS; those who purchased cigarettes at CVS as well as other retailers; and those who made these purchases exclusively at non-CVS retailers. Using retailers’ purchasing data, investigators also compared cigarette purchasing before and after tobacco removal in 13 states with a CVS market share of at least 15% (intervention states) versus 3 control states with no CVS stores.

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Rates of stopped buying cigarettes among CVS-exclusive purchasers (0.04 per household-month) were at least twice as high as rates among those who purchased cigarettes at CVS and other retailers and among those who purchased them exclusively at non-CVS retailers. In fact, compared with other exclusive purchasers, CVS-exclusive purchasers were 38% more likely to stop purchasing cigarettes. This likelihood was even greater for CVS-exclusive buyers who purchased 3 or more packs at a time.

Cigarette pack purchases in intervention and control states did not differ in the short term after CVS removed tobacco from its stores, but during an 8-month follow-up intervention-state smokers decreased cigarette purchases by a mean of 0.14 packs per smoker per month. Over time, each 5% increase in CVS market share was associated with a mean decrease of 0.15 packs per smoker per month (Polinski JM, et al. Am J Public Health. 2017;107[4]:556-562).

Thoughts from Dr Burke

This study was funded by CVS and performed by employees of the company. Nonetheless, we should applaud the corporate decision to eliminate cigarette sales and study its public health impact. CVS-exclusive households were more affluent and bought fewer cigarettes at baseline than other households surveyed. The reduction in cigarettes bought by CVS-only customers (0.14 pack/smoker/month, about 3 cigarettes) is small but could be significant across a large population. The same is true of the small but significant number of households with smokers who bought no cigarettes in the months after the CVS change.