US Food and Drug Administration Inspection of Tobacco Sales to Minors at Top Pharmacies, 2012-2017

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Abstract
Pharmacies face increasing pressure to abandon tobacco sales, as CVS Health did in September 2014.1 Although selling tobacco, the leading cause of preventable death and cardiovascular disease, is incongruous with promoting health and wellness, tobacco sales in pharmacies totaled almost $5 billion in 2012.2 At one pharmacy chain, approximately 1 in 20 customers who filled prescriptions for conditions that are exacerbated by smoking also purchased cigarettes.3 Corporate-owned pharmacies also sell cigarettes at significantly lower prices than most other types of tobacco retailers.4 Low prices raise concern about pharmacies as a source of illegal tobacco sales to minors. In 2012, an estimated 7% of youths who smoked reported purchasing cigarettes at pharmacies in the past month.5 For these reasons, we examined the inspections of tobacco sales to minors conducted by the US Food and Drug Administration (FDA) in approximately 13 200 pharmacies in 49 states and Washington, DC, from January 1, 2012, to December 31, 2017.