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Comment on CVS Caremark pharmacies to halt tobacco sales

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Tobacco does have some well documented medicinal qualities, believe it or not. There's no shortage of things at CVS that can harm through abuse.

Nicotine has a lot of really great qualities, but anyone trying to justify smoking or chewing tobacco for its medical benefits is in denial.

There are a lot of people who have found that one or two cigarettes a day keeps depression at bay. There are biochemical reasons to believe them. Who are you to tell them they should have to get a prescription SSRI?

That would be the nicotine stimulating the release of glutamine and dopamine. The value there is in the nicotine, not in the tobacco. You can get nicotine separately from tobacco trivially.

The false choice of cigarettes or SSRIs is silly.

It's not just nicotine. Tobacco smoke has compounds like beta-globulines that lower serotonin and estrogen. There are also arguments that low doses of carbon monoxide can have therapeutic affects.

...but reduced serotonin levels are linked to depression. The entire point of SSRIs is to keep your serotonin levels higher and thus improve synaptic signalling. Wouldn't reducing your serotonin production be bad?

Edit: Here's a link to a cross-sectional study showing a cause-effect relationship between smoking and depression. http://bjp.rcpsych.org/content/197/5/413.full

That's a point of debate, actually. SSRIs in the long term appear to actually work by reducing serotonin in the brain tissues.

Serotonin is really more of a torpor hormone that depresses the whole body than a "happy" neurotransmitter. It's associated with hibernation, for example. The "turkey causes sleepiness" meme is about tryptophan in the meat boosting serotonin levels.

That's clearly not how it's being used in this case.

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