Cigarette Purchases Commonly Accompany Asthma Prescription Refills

OCTOBER 21, 2014
Katie Eder, Senior Editor
Even though smoking can exacerbate respiratory conditions and limit the efficacy of their treatment, patients often purchase cigarettes while filling prescriptions for asthma or antihypertensive drugs at pharmacies, a research letter published online on October 20, 2014, in JAMA Internal Medicine has found.
For the study, a team of researchers analyzed 361,114 patients who received pharmacy benefits through CVS Caremark, the prescription benefit management subsidiary of CVS Health, and filled a statin prescription between January 2011 and June 2012, prior to the company’s move to discontinue tobacco sales.
Within that cohort, the researchers identified 38,393 patients who filled a prescription for an antihypertensive, asthma or chronic obstructive pulmonary disease (COPD), or oral contraceptive (OC) medication. Among those patients, 6% of those taking an asthma or COPD medication, 5.1% of those taking an antihypertensive drug, and 4.8% of those using an OC medication made at least 1 cigarette co-purchase. Furthermore, roughly 1 in 20 patients taking medications across 3 of those drug classes made cigarette co-purchases every other month, on average, at the pharmacy.
The researchers pointed out that cigarette smoking can impair respiratory disease management, increase the odds of atherosclerosis and coronary heart disease among those with hypertension, and raise the risk of myocardial infarction and venous thromboembolism among OC users aged older than 35 years.
“A visit to the pharmacy to fill a prescription is, paradoxically, often an opportunity to purchase cigarettes,” the authors of the research letter noted. “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.”
The study was supported by an unrestricted grant from CVS Health to Brigham and Women’s Hospital.