On the Irrationality of the San Francisco Pharmacy Cigarette Sales Ban: You Can Buy Tobacco at Some Walgreens, But Not Others

In light of the city's ban on tobacco sales in pharmacies, which is now in effect, if you go to a Walgreens in San Francisco today, will you be able to buy cigarettes?

The answer, it turns out, is: "It depends."

Some Walgreens stores will continue to sell cigarettes, while others will not. If you like purchasing your cigarettes at Walgreens, you can continue to do so; you simply have to change the Walgreens location you go to if you happen to go to one that has removed cigarettes from its shelves.

Walgreens stores that contain pharmacies were forced to remove their cigarettes. However, Walgreens stores that do not contain pharmacies will continue to sell cigarettes.

Here's another question: In light of the ban on tobacco sales in pharmacies, will you be able to buy cigarettes today at a CVS that contains a pharmacy? Will you be able to buy cigarettes at a Costco that contains a pharmacy?

The answers are no and yes, respectively. A CVS that contains a pharmacy will not be able to sell cigarettes. However, a Costco that contains a pharmacy will be able to sell cigarettes.

The arbitrary nature and inconsistency of the policy is pointed out in a San Francisco Chronicle column today, which argues: "San Francisco has a lot of great ideas. The Board of Supervisors' vote to ban the sale of cigarettes at pharmacies such as Walgreens and Rite Aid wasn't one of them. ... 'We don't sell cigarettes out of vending machines or in schoolyards,' said the mayor's spokesman, Nathan Ballard. 'We don't sell cigarettes at hospitals. And we shouldn't sell cigarettes at pharmacies. People go to a pharmacy to get well, not to die a slow, agonizing death from lung cancer.' I couldn't agree more. If walking into a drugstore means dying a slow agonizing death, by all means let's close all of them immediately. But it isn't the pharmacy that causes lung cancer, it's the tobacco. In fact, an argument can be made that buying cigarettes at a pharmacy includes an incentive - albeit a small one - to stop the habit. 'I'd prefer that smokers buy their cigarettes where they are reminded that smoking is not a good thing,' Elsbernd said. 'Where products for smoking-cessation are on display.' And then there is the issue of how and why pharmacies at Walgreens and Rite Aid were singled out. 'My thought was, if you are going to ban people from buying cigarettes, do it everywhere,' Elsbernd said. 'And if we are talking about pharmacies, why not all pharmacies?' Instead, not only are small, mom-and-pop pharmacies excluded, so are some of the biggest stores in the city. 'Safeway and Costco continue to sell tobacco products even though they have a pharmacy,' Dufty said. 'It makes me crazy.'"

The Rest of the Story

This highlights why I argue that the ordinance represents an arbitrary and capricious application of government regulation, rather than a rational one. How can the city argue that it must ban cigarette sales in one store that contains a pharmacy (CVS, Walgreens, etc.) but not in another one (Costco, Safeway, etc.)?

It is also difficult to see a rational basis for a regulation that imposes a ban on cigarette sales in some CVS and Walgreen stores but not others. Why must the city ban cigarette sales at some CVS stores but not at others? Does the public look at CVS stores differently based on whether they have a pharmacy?

Of course, the trouble comes from the fact that the city is trying to regulate an area in which there is not a substantial government interest: ensuring that stores sell products which are consistent with their perceived (though not necessarily stated) mission. When you do that, you're bound to get into this kind of trouble.

The problem is that the city has overstretched the bounds of regulation based on direct public health protection.

To me, however, the most interesting aspect of this story is that anti-smoking groups continue to support these regulations. This is yet another example of blind adherence to a theology in which any regulation of tobacco is good. Thinking, analysis, and rational argument do not enter the picture. You do not have to defend the rationality of your proposal. If it is intended to be anti-tobacco, that is enough.

And of course, the corollary of that is that anyone who opposes such a regulation is pro-tobacco and most likely a front for Big Tobacco. So merely by publishing this piece, I am going to be viewed by those in the field as a tobacco stooge. That would be a price worth paying, if only these groups started to actually analyze and defend their proposals against criticism, rather than simply exhibiting knee-jerk support for any policy that is ostensibly "anti-tobacco."