Objective The states of California and Massachusetts are leading the effort to prohibit the sale of tobacco products in pharmacies in the United States. The process of adopting these tobacco-free pharmacy laws remains understudied. This study qualitatively explores the process of adopting and enforcing tobacco-free pharmacy laws. Methods Researchers performed qualitative semistructured telephone interviews with 23 key informants who were involved in the effort to adopt and implement tobacco-free pharmacy laws in California and Massachusetts. A content analysis was used to study the process of adopting tobacco-free pharmacy laws as well as barriers and facilitators during the process. Two researchers independently coded the interview transcripts and written responses to identify key categories and themes that emerged from the interviews. Results The qualitative study results suggest that the process of adopting the tobacco-free pharmacy laws was fairly smooth, with a few barriers. Local youth groups and independent pharmacies played an important role in raising public awareness and attracting media attention. The results also highlighted the need to regulate the sale of e-cigarettes as a part of tobacco-free pharmacy laws. Conclusion As the number of cities that have adopted tobacco-free pharmacy laws grows, banning tobacco sales in pharmacies is becoming less controversial and more normative to both pharmacy retailers and the public. Our findings inform the ongoing discussion about tobacco-free pharmacy laws and are useful for decision-makers from communities that are considering such laws.