High noon for cigarettes

FIVE YEARS after Boston became a national leader in tobacco control by banning smoking inside restaurants and bars, the Boston Public Health Commission gave preliminary approval last week to new regulations that would ban sales of tobacco products at drugstores and on college campuses. The Marlboro Man may not be under a tombstone, but the public health posse is making it even more clear who runs Dodge.

The measure, which still faces a public comment period, would end the longstanding hypocrisy of pharmacies selling both the drugs to prolong life and the one product that is the leading preventable cause of death in the world. The city of San Francisco is about to become the first city in the nation to ban cigarette sales in drugstores. Much of Canada has such a ban, to dramatic benefit. Last week, the Canadian government said teen smoking since 1999 has been nearly halved, from 28 percent to 15 percent.

Barbara Ferrer, the executive director of the Boston Public Health Commission, said the action was not about being a nanny state. She said tobacco, a product with no redeeming value, belongs in the highly regulated category of guns and alcohol. "It is not enough to say eat well, exercise, and don't smoke," she said. "You have to promote the conditions that promote people taking care of themselves."

Tobacco, as its defenders like to point out, is still a legal product. But unlike candy or soda, it is intentionally addictive, and is lethal even when used as directed. Restricting its access is squarely within the public health department's mission.

The nation's top two drugstore chains, Rhode Island-based CVS and Walgreen's, showed no major sign of ending cigarette sales voluntarily. In May, Walgreen's CEO Jeff Rein told analysts, "One thing I'd like to make clear is we are definitely not becoming a healthcare company. . . . If you're going to go into a store, and you're going to see various accessories - it could be toys, it could be candy, cosmetics, it could even be cigarettes. How does that mesh with health? In many cases, it does not."

Thomas Ryan, the chief executive of CVS, has said ending the sale of cigarettes is "something we wrestle with." He told a Reuters health summit last year, "It is a conflict. We have a vision in our company to strive to improve human life and it is a challenge around cigarettes. It's a big number from a dollar standpoint." But, he added, "I wouldn't rule it out at some point."

Boston and San Francisco are ruling it out for him. It is good to see the public health posse stride down the street, unafraid of another showdown with Big Tobacco.