Research Letter: Cigarette Purchases, Accompany Prescription Refills at Pharmacies


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JAMA Internal Medicine

Bottom Line: Patients using medication to treat asthma or chronic obstructive pulmonary disease (COPD), high blood pressure and using oral contraceptives (OC) often purchased cigarettes while filling prescriptions at pharmacies.

Author: Alexis A. Krumme, M.S., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues.

Background: Smoking cigarettes can make managing a chronic disease more difficult. Visiting a pharmacy to fill a prescription can be a chance to buy cigarettes. Smoking can exacerbate respiratory conditions, make it more difficult to control blood pressure and can raise the risk of heart attack and blood clots in OC users older than 35 years.

How the Study Was Conducted: The authors drew study participants from a group of 361,114 patients who received pharmacy benefits through Caremark and filled a statin (medication to lower cholesterol) prescription between January 2011 and June 2012. The researchers included linked data from all purchases at CVS retail locations made with a CVS loyalty card.

Results: Of the 38,939 patients taking medication for asthma or COPD, high blood pressure or using OC, 6 percent of asthma or COPD medication users, 5.1 percent of antihypertensive medication users and 4.8 percent of OC medication users had at least one cigarette co-purchase.

Discussion: “The decision of some pharmacies, including CVS, to stop selling cigarettes has been met with widespread support from public health and medical organizations. Similar actions by other pharmacies may help prevent cigarette purchasing by individuals at greatest risk.”

(JAMA Intern Med. Published online October 20, 2014. doi:10.1001/jamainternmed.2014.5307. Available pre-embargo to the media at

Editor’s Note: This study was supported by an unrestricted grant from CVS Health to Brigham and Women’s Hospital. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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