Tag Archives: CVS

Demonization of tobacco users (or, just because it is a puff piece does not mean I cannot analyze it)

by Carl V Phillips

Vapers are delightedly tweeting this bit of satire from The Daily Mash, entitled,”Put cancer in e-cigarettes, say non-smokers.”  The conceit is that THR causes non-smokers to lose their feeling of superiority, forcing them to frequent crack houses to recapture that old feeling (a gateway theory?).  I saw it tweeted as “anti-smokers” rather than “non-smokers”, but this actually missed the point:  The characters in the story are not anti-smoking; they like smoking and its ill-effects due to the schadenfreude.

This contrasts with professional anti-smokers — or more accurately, the tobacco control industry, anti-tobacco extremists, or ANTZ — who also favor keeping tobacco use harmful, but for somewhat different reasons.  As noted from the start in this blog, anti-THR has several motives, all of them perverse, and none of them having to do with health even though the anti-THR liars cloak themselves with the title “public health”.

The anti-THR activists consider tobacco use to be some kind of moral failing or otherwise just want to eliminate it, and thus prefer to keep it as harmful as possible.  For the less-bright majority of that crowd, this is for motives as base as those in the Daily Mash story:  They are annoyed that tobacco users will not obey, and want them to suffer for their temerity.  But the smarter tobacco controllers, those who talk about “endgame” or “tobacco-free by 2030”, know that low-risk alternatives guarantee that they will fail:  So long as tobacco use is highly harmful (i.e., smoking), everyone has a good reason to quit.  While it is unlikely they will all do so, there is a chance.  But low-risk tobacco products have benefits that greatly exceed their costs, and so people do not have an incentive to quit, and sensible politicians have no reason to support measures to discourage use.  Moreover, the realization that tobacco use is becoming low-risk will inevitably cause a backlash against the entire anti-tobacco industry and their lavish use of our tax money.

But unlike the characters in the Daily Mash story, the tobacco control industry cannot ever admit their motives.  Even if they preferred telling the truth over lying (though there is no evidence that suggests this is the case), they would have to lie about this one.  The mere admission of their real motives would derail the entire enterprise.  Of course, the cannot make e-cigarettes more hazardous than they are, like the characters in the story wish, but they can try to trick people into believing that e-cigarettes and smokeless tobacco are high-risk, and thus encourage them to smoke instead.  As long as most tobacco users are smoking, the tobacco control industry can continue to profit and dream.

In a less puffy piece that also pursued the theme of people feeling superior to smokers, the New Republic called for an end to campaigns to stigmatize smokers.  It likened the stigmatization of smokers to the stigmatization of people with HIV/AIDS.  This is a valid moral equivalence.  In both cases, it is about a behavior that someone is choosing to engage in, which happens to be something that a tiny minority violently objects to as immoral.  In both cases, that tiny minority uses the health risk (and the grossly exaggerated tiny spillover risk to others) as a convenient tool for making it appear that their motives are something other than hatred.  This allows them to enlist the support of others who vaguely disapprove of the behavior, but not so much that they would deny others their free choice based on that disapproval, let alone would intentionally inflict punishment on the “sinners”.  The article seals the comparison by looking at the stigmatization of lung cancer victims.

The article fails to note that the portion of lung cancer is caused by smoking is smaller than the portion of HIV infection that is caused by various demonized behaviors.  Nor does it point out that anti-smokers are exactly the same violent and hate-fueled people as gay bashers — which of those two a particular person turned out to be is just an accident of what subculture he grew up in.

Unfortunately, some of the analysis is the article is not so good.  It suggests that tobacco control efforts have played a large role in reducing smoking, when actually almost all the credit goes to simple knowledge and rational consumer choice.  It also conflates genuine effects of smoker demonization with statistics like “Most non-smokers would be reluctant to date someone who smokes (72%).”  There are perfectly legitimate reasons for making that personal choice that do not imply a dislike of smokers, let alone a desire to inflict psychological violence on them or schadenfreude.

The hook for the New Republic story, and a companion piece, was the CVS move to stop selling cigarettes.  The quotes about that in the articles, and to a lesser extent the articles themselves, show more of the naivety about it explored in my previous post.  It is amusing that those praising the move simultaneously describe it as “courageous” and “principled” and also claim it will be good for business (or naively believed that because CVS stock price upticked, it proves it was good for business).  I suppose it is not too shocking that those innumerate people cannot figure out the laughable contradiction there.

Of course, that does not explain why removing a product from the shelves — with a predicted substantial loss in revenue — is good for business.  As I noted before, it appears that the answer is that it gets them more corporate customers for their much-higher-margin medical service businesses.  But why? Basically because the business leaders have been strong-armed by the tobacco control industry (particularly including its units in government) into pushing their medical service suppliers to not sell cigarettes.

This creates an amusing contradiction for the doctrinaire free-marketeers, some of whom praised the CVS decision as a free choice of a business in the market.  When market decisions are caused by tax-fueled campaigns to force companies to change their behavior, what exactly does “free market” mean? Also, how perfect is the market if the CVS customers who are companies make decisions based on non-market influences that would not affect individuals (there cannot be 1000 people in the country who avoid buying from CVS when they offered the best value, just because they sell cigarettes)?

But while the free-market extremists get a lot of things wrong, the core points about markets are right.  In particular, the more merchants stop selling cigarettes, the greater the profits for those who still do (volume will clearly increase, and per-unit profit will also inch up due to the reduced competition). Thus, however much political pressure there is to make the “free” decision to stop selling cigarettes, there will be an equilibrium when that is not enough to offset the available profits and cause more merchants to exit the market.  My suspicion is that the “endgame” types have no idea that this is the case.

Finally, for those who have been missing my writing about THR for the last week and a half, it is because you are not reading EP-ology, where I posted two pieces on the topic (as well as other interesting stuff).

CVS and cigarettes, an embarrassing Rorschach test

by Carl V Phillips

Presumably anyone who reads in this area is already aware that the CVS drug store chain announced that they will stop selling cigarettes and other tobacco products.  The practical consequences of this are almost nil, but the response to it are rather educational.  It is a veritable Rorschach test (though not exactly the same, since no one seems to have said “it looks like a butterfly” or likened the announcement to some bit of the female anatomy).

The immediate practical consequences of the move are:  (a) CVS will lose $2 billion/year in revenue, by their own estimate; (b) some smokers will have to make an extra stop if they want to buy both toothpaste and cigarettes; (c) C-stores and other competitors will thus gain about $2 billion/year in revenue; (d) some C-store may also increase their profit margin on cigarettes because they no longer have to price-compete with a nearby CVS.  It is probably also the case that: (e) tobacco companies will increase their profits a bit because CVS’s size allowed it to negotiate better wholesale prices for cigarettes than their average competitor.

Of course, none of those could possibly be the motive for the decision.  To the extent that I have seen cogent explanations of the motives, it appears to have happened because CVS’s biggest cash cow and growth area is not retail, but providing insurance-like services to big companies.  Apparently their clients and potential clients (presumably strong-armed by the tobacco control industry) pressured CVS into making the move.  Assuming this is true, it was a symbolic gesture in which they decided to take something away from their peon retail customers in order to please (not even materially benefit) their big corporate customers who offer much bigger margins.

Of course, that is not how they spun it to the public.  It very convenient when you can spin a sacrifice you are forced to make (in order to get some benefit) as a good thing in itself rather than a price paid.  So, of course, CVS claimed exactly that in their (transparently false) public statements — it was a principled decision because they did not feel that people should be buying cigarettes the same place they are buying medicines.

The most obvious hypocrisy in that spin has been pointed out by pretty much every commentator on the topic, even those that know little about tobacco:  CVS sells — right up front in their most prominent displays — unhealthy snack foods, “energy drinks”, candy, and so on, so this is clearly not about removing products because they are unhealthy.  A more sophisticated take on the hypocrisy comes from the observation that they are removing not just cigarettes, but smokeless tobacco.  If this were really about health, they would have kept the latter and steered would-be cigarette purchasers to this low-risk alternative.

What is most interesting, however, is how the tobacco control industry went gaga over this move that had only symbolic consequences.  The Robert Wood Johnson Foundation added it to their animated timeline of the most important moments in the history of tobacco control (and apparently did so within minutes of CVS’s announcement — not that this proves that the surprise announcement was actually an orchestrated conspiracy or anything).  Then @RWJF_PubHealth tweeted about this addition approximate once per hour, and even paid to promote the tweets (must be nice to be able to pay to get people to look whenever you update your website).

The Rorschach test tells us the tobacco control industry is so starved for anything they can call a victory that they celebrate this useless gesture.  They are beside themselves with delight that smokers who are shopping at CVS will now have to go cleeear to the nearest C-store to buy cigarettes. To the present generation of tobacco controllers, this is all they can add to the list that includes such genuinely important moments as the 1964 Surgeon General report, the groundbreaking epidemiology on smoking from the 1950s, and….  Well, actually those are really the only things that ought to appear on a story of the great moments in anti-smoking.

Of course, that RWJF timeline is not actually about successes of tobacco control (i.e., events that reduced smoking), but successes of the the tobacco control industry (i.e., events that demonstrated and/or increased their power and wealth, or inflicted punishment on tobacco users for their sins, even though almost all were inconsequential in terms of reducing smoking).  In that sense, I suppose, this was a victory for them.

While desperation for something to claim as a victory, along with boasting about their ability to exercise power, probably explain most of the TCI reaction, to some extent it is genuine innumeracy (albeit intentionally-cultivated — i.e., lie-based — innumeracy).  Notice that the above list of consequences of CVS’s move did not include “there will be less smoking”.  This is because of the obvious fact that one fewer retailer of cigarettes has absolutely no effect on the demand for cigarettes, and it is the demand that matters.  Or, as I tweeted about it, “#CVSQuits selling cigarettes. Tobacco controllers demonstrate their continued failure to understand supply is not demand by celebrating.”

Part of the core myth of tobacco control is that there is no demand for tobacco, and that the reason people consume it basically demonic possession.  So, the “reasoning” goes, since demand is not causing consumption — contrary to what anyone with a modicum of knowledge about economics or human beings would conclude — then it must be supply.  Ergo, eliminate some of the supply and you eliminate some of the consumption.

But it is not just the TCI who saw what they wanted to in CVS’s move.  NJOY and other e-cigarette companies, as well as many vapers, celebrated this as a victory for e-cigarettes.  Huh?  There are some reports that CVS specifically promised they would also not sell e-cigarettes after the removal date, though there are also contrary reports on this point.  But either way, the fact that they are removing low-risk tobacco products along with cigarettes does not exactly suggest that they will be restocking the back wall with a different low-risk tobacco product.  Moreover, it is not as if the TCI bullies who leveraged this move in the first place are going to let up on e-cigarettes, and so CVS will probably be pressured into not selling them either.  E-cigarette merchants and cheerleaders need to figure out that each restriction on cigarettes should be interpreted not as “more for us”, but as “you’re next”.

Indeed, the backlash resulting from a (very hypothetical) principled stand by CVS — were they to insist that e-cigarettes are pro-health and therefore they are going to sell them — would probably be increased as a result of them already caving on cigarettes.  Once you cave to someone’s political pressure — giving up billions in revenue to get some goodwill — they own you.  The revenue is gone, but they can still take away the good will that justified the loss, and so they have even more power over you than they did before.

So while it is possible that CVS will be stocking e-cigarettes instead, it seems ridiculously optimistic to assume they will, or even to conclude that it is more likely to happen given the removal of cigarettes than would be the case had they kept them.  And this is to say nothing of the fact that it is better to have e-cigarettes displayed next to where people are buying their cigarettes so they might spontaneously choose to try the former.  Bottom line:  What some elements of the e-cigarette community saw in the inkblot also suggests they suffer from some of the same problematic thinking as the TCI — not nearly as badly, for sure, but remarkably similar.

The final category of reaction I will note is that of every single smoker who was quoted in the mandatory “we asked this random shopper” section of news reports about the move.  Unsurprisingly, the reaction was basically, “Really? Oh well, I guess I will have to buy my cigarettes somewhere else.”  There were barely even any hints of annoyance.  You could almost hear the subtext: “My dry cleaner does not sell cigarettes. My bank does not sell them, nor does McDonalds.  Now my usual drug store won’t either.  But so what?  It is not like I can’t go to a gas station / 7-11 / other drug store / etc.”  In this population — the people who know best, after all — it never even crossed their mind that change in one source of supply would have any effect on demand.