Should pharmacies sell tobacco?

New research suggests that limiting tobacco sales to pharmacies, liquor stores or petrol stations could reduce the availability of tobacco as well as smoking cues

Researchers from the University of Otago looked at the potential impact of tobacco being only available from one of these types of outlets.

The study, led by Dr Louise Marsh from the Social and Behavioural Research Unit in the University’s Department of Preventive and Social Medicine, found that pharmacies would be second to petrol stations in reducing the number of tobacco outlets per smoker.

“Tobacco retailers and pharmacies were mapped using GIS. Comparisons were made between tobacco retailers and pharmacies. Simple linear regression was used to assess the relationship between outlet types and deprivation,” the authors wrote.

The research identified a total of 5,243 tobacco retail outlets in New Zealand: convenience stores (46%), liquor stores (17%) and supermarkets (13%). Based on 502,000 current adult smokers, this currently means there is about one tobacco outlet for every 115 smokers.

That would reduce to one tobacco outlet for every 692 smokers if the product was only sold through liquor stores, 582 smokers if only sold through pharmacies, or 576 smokers if only sold through petrol stations.

Dr Marsh said that substantially reducing tobacco availability has been identified as a crucial tobacco control strategy both internationally and in New Zealand and the study shows there would be an important reduction in overall availability of tobacco if sales were restricted.

“Decreasing the number of outlets that stock tobacco would help reduce youth smoking initiation, change community norms around tobacco use, decrease cues to smoke, particularly among those trying to quit and reduce the density of tobacco sales around schools,” she said.

However, the research highlights inequities in availability would exist with access to tobacco in rural areas disproportionately reduced with fewer liquor stores or pharmacies, potentially resulting in increased travel costs for Māori and rural smokers to purchase tobacco.

“With the tobacco retailer scenarios examined in this study, there would be a reduction from 54% of schools having at least one tobacco retailer located within 500m under the status quo to 22% of schools having at least one pharmacy located within 500m, 19% having a petrol station located within 500m, or 17% of schools having a liquor store located within 500m,” the authors wrote.

“Evidence shows that the more tobacco retailers there are around a school, the more likely are students to have ever smoked, engaged in experimental smoking and be susceptible to future smoking.”

They also identified some positives and negatives from tobacco being available from pharmacy.

In addition to the overall reduction in the availability of tobacco, the positive aspects of tobacco being only available through pharmacies are the potential for reduced opportunity for the sale of tobacco to minors, reduced operating hours, and that pharmacists are already trained to provide brief smoking cessation interventions,” the wrote.

“In addition, there may also be increased footfall into stores, which may result in sales of additional products.”

However there could be disadvantages for pharmacy in such a move, they warned.

“The potential disadvantages for pharmacies include increased theft – although they do currently have existing security systems for medications – and increased workload, as well as damage to their reputation from the contradiction of distributing medications and promoting health while selling tobacco, and also contributing to the normalisation of smoking.

“In addition, this policy is only feasible if there is support from pharmacists for selling tobacco.

“A small New Zealand study to gauge support among pharmacists for selling tobacco, if it was not available elsewhere, found that 26% of pharmacists interviewed thought it was ‘very likely’ to ‘extremely likely’ that their pharmacy would sell tobacco.

“This increased to 37% if it was shown that this strategy was successful elsewhere.”

The study has been published in the Australian and New Zealand Medical Journal of Public Health.

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