Background Several US jurisdictions have adopted policies prohibiting pharmacies from selling tobacco products. Little is known about how pharmacies contribute to total cigarette sales.

Methods Pharmacy and total cigarette sales in the USA were tabulated from AC Nielsen and Euromonitor, respectively, for the years 2005–2009. Linear regression was used to characterise trends over time, with observed trends extrapolated to 2020.

Results Between 2005 and 2009, pharmacy cigarette sales increased 22.72% (p=0.004), while total cigarette sales decreased 17.43% (p=0.015). In 2005, pharmacy cigarette sales represented 3.05% of total cigarette sales, increasing to 4.54% by 2009. Extrapolation of these findings resulted in estimated pharmacy cigarette sales of 14.59% of total US cigarette sales by 2020.

Conclusions Cigarette sales in American pharmacies have risen in recent years, while cigarette sales nationally have declined. If current trends continue, pharmacy cigarette market share will, by 2020, increase to more than four times the 2005 share.