In the ‘50s and ‘60s, a cigarette was as common a sight as a cup of coffee — a fixture in smoke-filled boardrooms, living rooms, and even airplane cabins, where passengers lit up complimentary packs mid-flight. The act of smoking wasn’t just normalized; it was a cultural rite of passage and sold as a symbol of sophistication and modern living.
But over time, the soft snap of a cigarette lighter igniting became a relic of the past. Smoking bans reshaped public spaces, warning labels replaced glamorous ads, and the conversation shifted from elegance to disease. In fact, between 2015 and 2021, annual cigarette sales dropped 27 percent, down by 70 percent since the ‘80s.
Today, the discussion around nicotine use has evolved dramatically, and health-wise, the stakes for quitting have never been higher: More than 480,000 deaths per year are caused by smoking, and research shows that quitting can add up to ten years to a person’s life expectancy by reducing the risk of lung disease, cancer, and cardiovascular complications.
With growing awareness of the long-term health consequences, fewer Americans than ever are lighting up traditional cigarettes. However, tobacco remains a key public health issue as smoking remains the number one cause of preventable death in the world. Additionally, while tobacco use in the U.S. continues to decline, newer alternatives — vaping and nicotine pouches — have taken hold, particularly among younger generations, and they remain highly addictive.
Putting public health over profits
Few companies have taken a stronger stand against smoking than CVS Health, which made a game-changing decision in 2014 to stop selling tobacco products altogether — a move that cost the company an estimated $2 billion in revenue. The financial loss was significant, but the impact on public health was even greater. A year after CVS Pharmacy removed cigarettes from its shelves, 100 million fewer packs were sold nationwide, proving that eliminating easy access to tobacco could influence consumer behavior.
David Fairchild, MD, Senior Vice President and Chief Medical Officer of Retail Health at CVS Health, believes this decision was pivotal in the company’s transition to becoming a true health care organization. “We put our money where our mouth was,” says Dr. Fairchild. “It was an expensive decision, but it was the right thing to do. And even today, a decade later, people still remember that CVS stopped selling tobacco.”
Are vaping and nicotine pouches the next epidemic?
Instead of Marlboros or Virginia Slims, high schoolers today are reaching for sleek, USB-shaped vapes and discreet nicotine pouches by companies like Zyn, drawn in by the promise of a “cleaner” fix. In a recent CVS Health Harris Poll survey* on tobacco use in the U.S., 77% of Gen Z and young adult respondents ages 18- 28 that use nicotine said they use e-cigarettes or vapes, and 28% believe e-cigarettes are less harmful than traditional cigarettes.
The rise of these alternatives has sparked a heated debate: Are these products helping reduce smoking rates, or are they creating a new generation of nicotine addicts?
“It’s not black-and-white,” says Dr. Fairchild. “On one hand, vaping can be a helpful tool for people trying to quit smoking. But on the other, we’ve seen it become incredibly popular among young people — many of whom never would have smoked cigarettes in the first place.” Flavored vape products, in particular, have made nicotine more appealing to teenagers and young adults, blurring the line between harm reduction and addiction promotion.
While studies on the long-term effects of vaping are still in progress, early research raises concerns about the impact of nicotine on developing brains. “Nicotine is highly addictive, and for young people, it can actually affect brain formation,” Dr. Fairchild explains. “We don’t yet know the full extent of the risks, but we do know that early exposure to nicotine increases the likelihood of lifelong addiction.”
Regulations have tried to keep up, with bans on flavored vapes and increased restrictions on sales. But as Dr. Fairchild points out, easy access remains an issue. “Seventy percent of Gen Z and young adults surveyed in CVS Health’s recent survey believe if fewer stores sold nicotine products, it would help to reduce teen use. You walk into a gas station, and there’s an entire wall of nicotine products. They may not be cigarettes, but they’re still designed to hook users and keep them coming back.” CVS has never sold vapes, e-cigarettes, or nicotine pouches in any of its retail locations, reaffirming the company’s dedication to promoting smoke-free lifestyles.
How to give up a nicotine addiction
For those who want to quit — whether it’s cigarettes, vaping, or nicotine pouches — the process can be daunting. “Nicotine addiction is tough,” says Dr. Fairchild. “Most people need multiple attempts to quit. It’s not a failure of willpower — it’s a medical condition, and we have to treat it that way.”
That’s where added resources come in: MinuteClinic, the medical clinic located inside select CVS locations, provides smoking and vaping cessation programs, offering personalized plans to help people quit. In-person and virtual visits are available. “We have nurse practitioners, physician associates, and pharmacists who can guide patients through their options — whether it’s nicotine-replacement therapy, medication, or counseling,” says Dr. Fairchild. “Having someone to support you through the process makes a huge difference.”
The long-term benefits of smoking cessation
Let’s face it: Quitting, no matter how long you’ve smoked, vaped, or used nicotine pouches, is worth it. “If you stop smoking, you can add up to a decade to your lifespan,” Dr. Fairchild says. “Even with all the progress we’ve made, smoking is still the leading preventable cause of death in the U.S. The good news is that when people quit, their risk of serious disease drops dramatically.”
The future of “smoking”
Looking ahead, Dr. Fairchild believes smoking rates will continue to decline, but it will be a “long game.” “The fact that young people aren’t smoking cigarettes the way previous generations did is a good sign,” he says. “But at the same time, we have to keep an eye on new nicotine products. The industry is always evolving, and we need to stay ahead of it.”
Ten years after CVS Health made its groundbreaking decision to stop selling tobacco, the company remains committed to the fight against nicotine addiction. “We took a stand because it was the right thing to do,” Dr. Fairchild reflects. “And we’re still working to help people quit — one conversation, one program, one patient at a time.”
The allure of taking a drag may be fading, but the battle against nicotine addiction is far from over. Many have yet to take their last puff — but for those willing to quit, the future looks a whole lot healthier. For more information visit CVSHealth.com/Tobacco.
The information provided on this site isn’t intended as medical advice, and shouldn’t replace professional medical treatment. Consult your doctor with any serious health concerns.
*This survey was conducted online by The Harris Poll on behalf of Kaplow/CVS Health among 512 US parents of teens/young adults ages 13-28 and 503 US Gen Z/young adults ages 18-28.
