Using tobacco retail licensing to restrict the sale of tobacco products in pharmacies: The San Francisco experience

Background: On August 7, 2008, San Francisco became the first US city to pass a local ordinance eliminating tobacco sales in pharmacies. Previous campaigns focused on education, raising awareness, voluntary policies, and shareholder resolutions to stop tobacco sales in drugstores. Methods: The existing tobacco permit ordinance was amended to eliminate tobacco sales from businesses where pharmacy services were rendered. Contributing factors to the successful adoption of the ordinance and survival of legal challenges included strong leadership from the Director of Health and Mayor's Office, community education and organizing by the LGBT Tobacco Education Partnership, public support, technical assistance from the Tobacco Free Project, and the City Attorney's legal expertise. In crafting the language of the ordinance, it was key to focus on regulating the conduct of the sale of tobacco. Arguments and data to support such a regulation were clearly articulated and supported by the ordinance findings.. Results: Initially the ordinance eliminated tobacco permits for establishments with pharmacies, while grocery and big box stores were exempted. San Francisco won a legal challenge from Philip Morris, which claimed the ordinance was regulating tobacco advertising. While the City did not prevail in the lawsuit filed by Walgreens, claiming their equal protection rights were violated by the exemption for grocery and big box stores, the larger public health goal of changing social norms about tobacco availability was achieved when the ordinance was further revised to remove the exemption for grocery and big box stores.