Cardiovascular societies praised CVS Caremark’s decision to phase out sales of tobacco products at its stores over the next year.

A viewpoint published online Feb. 5 in JAMA outlined the reasoning for the phase-out, which the co-authors estimated would cost CVS $1.5 billion annually. The co-authors—Troyen A. Brennan, MD, MPH, of Woonsocket, R.I.-based CVS Caremark, and Steven A. Schroeder, MD, of the Smoking Cessation Leadership Center at the University of California, San Francisco—pointed out the discord between pharmacies providing counseling and medications to improve health alongside smoking products that are known to have health risks.

Numerous associations, including the American Heart Association (AHA), the American Medical Association and the American Pharmacists Association, have encouraged pharmacies to cease selling tobacco products. Many developed countries already have banned retail sale of cigarettes and other tobacco products in pharmacies, the co-authors wrote, as have the cities of San Francisco and Boston.

The association between tobacco use and the risk of developing cardiovascular disease is well established. Other research has targeted second-hand smoke as possible hazard for acute MI, chronic obstructive pulmonary disease and other diseases and conditions.

American College of Cardiology President John G. Harold, MD, said in a statement that tobacco use accounts for about 40 percent of all heart disease-related cases in the U.S. “CVS is setting an important example putting public health above profit,” Harold said. “Tobacco use remains the leading preventable cause of disease, disability and death in the United States.”

AHA President Mariell Jessup, MD, characterized the decision in a statement as “a vital and important step as we begin the next chapter in our fight for Americans’ health. Fifty years after the U.S. Surgeon General first reported the scientific evidence that cigarettes kill, we still have so much more to do to prevent our children from starting the deadly habit and to help so many adults finally stop smoking.”

A nearly 1,000 page-report released by the U.S. Surgeon General earlier this year described tobacco use as an epidemic and attributed more than 20 million premature deaths since the first report’s publication in 1964 to cigarette smoking. In the preface, a message from U.S. Secretary of Health and Human Services Kathleen Sebelius may have provided a hint of what was on the horizon.  

“All of these tobacco control interventions are known to reduce tobacco use and, as a result, tobacco’s extraordinary toll of death and disease. But in order to free the next generation from these burdens, we must redouble our tobacco control efforts and enlist nongovernmental partners—and society as a whole—to share in this responsibility,” she wrote. “Ending the devastation of tobacco-related illness and death is not in the jurisdiction of any one entity. We must all share in this most worthwhile effort to end the tobacco epidemic.”