Tobacco reform gets lazy

On Monday the popular consultation of Health on the extension of the anti-smoking law closes | Experts recognize that it contemplates important changes, although not enough

At this point, no one doubts the impact of the anti-tobacco law in the fight against smoking. The anti-smoking law of 2005 and its extension in 2010, through which smoke-free spaces were expanded – smoking was prohibited in playgrounds, and in the premises of educational and training centers dedicated to minors and health centers – were among the most advanced in Europe. However, the lack of new measures in the last decade has made Spain fall back on the list of tobacco control policies.

According to the experts, the stabilization in the reduction of the prevalence of tobacco consumption and the increase in that of products related to it; exposure in general, and in particular of young people, to new forms of nicotine consumption; the lack of adaptation of the current regulations to the offer of new tobacco products; the maintenance of the attractiveness of tobacco packaging, and the deficiencies in the regulation of electronic cigarettes make it necessary to take a step forward and undertake more ambitious measures, as other countries around us have already done.

Adapting the standard to this reality, very different from what occurred in 2010, is the objective of the draft of the Comprehensive Plan for the Prevention and Control of Smoking 2021-2025, a document agreed upon by scientific societies, experts in smoking and patient associations and which is already two years late. At the same time, the Government is preparing a reform of the anti-tobacco law, whose popular consultation closes this Monday, the 24th, which focuses on generic labeling and the regulation of emerging tobacco products, two measures that entities such as the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) have been suing for years, although they are insufficient, they warn, to face the biggest public health problem in the country and the leading cause of preventable death – between 2020 and 2021 smoking claimed the lives of 120,000 Spaniards (some 5,000 more deaths than COVID).

For the Galician pulmonologist Carlos Rabade Castedo, coordinator of the executive committee of the Smoking Department of SEPAR, the measures proposed by the Ministry of Health are minor. “It is true that the measures proposed by this regulation are important, such as the regulation of electronic cigarettes and generic packaging, but they are still measures that are already in the comprehensive plan, which includes much broader measures to solve the problem of smoking. We are not facing a minor problem, so we cannot take minor measures. However, we do not see the will to put it into operation and that it leads to a new anti-smoking law that is very necessary at the present time& rdquor;, affirms the pulmonologist.

Among the measures that are inalienable for Rábade are the extension of the ban on smoking or vaping in open public spaces such as terraces; guarantee a provision of assistance to smokers throughout Spain; raise awareness among the population in relation to smoking and its emerging products, and hinder access to all tobacco products with measures such as price increases.

In fact, raising tobacco prices by increasing taxes is considered by the World Health Organization (WHO) to be the single most effective measure to reduce tobacco consumption. “Spain is a very cheap country to smoke,” says Rábade.

They warn of a stabilization in the reduction of smoking

The effects of the fact that no new measures regarding smoking control have been approved since 2010 are reflected in the latest surveys, both “AGES & rdquor; such as “ESTUDES& rdquor ;, which reveal that there was a reduction in the prevalence of smoking, especially during the first years of the 2010 law, but that it has stagnated. “We are seeing a slowdown in the reduction of tobacco consumption and in this situation it is essential to adopt more ambitious measures & rdquor ;, he says.

The doctor Monica Perez Rios, Professor of Preventive Medicine and Public Health at the University of Santiago (USC), recalls that in Spain the impact of tobacco use on mortality is estimated at around 60,000 deaths per year, of which 8 out of 10 occur in men. Likewise, the estimate of mortality attributed to exposure to tobacco smoke is around 750 deaths.

“The Law on sanitary measures to control smoking, especially its extension of 2010, meant a very advanced law, but one that has become obsolete, so it is essential to advance in the legislation to control smoking, something that has been stopped since 2010, that is, for more than 12 years,” says the epidemiologist, for whom it is necessary to denormalize consumption through campaigns aimed at more young people to prevent them from starting to smoke and others aimed at smokers to encourage quitting. “In countries like Brazil, very powerful campaigns aimed at informing the population about the risks associated with exposure, especially in children, had a very positive impact both on the prevalence of consumption and on the decrease in exposure to environmental tobacco smoke& rdquor; , exposes.

For jesus cancel, clinical psychologist and director of the Alborada, the Vigo Citizen Association to Fight Drugs, the reform of the anti-smoking law is “absolutely necessary & rdquor; and ensures that it must focus on measures aimed at avoiding or delaying the start of tobacco consumption as much as possible, among them, the taxation of these products to discourage consumption, and the education of the population.

“Tobacco is the starting substance for addictions. This does not mean that everyone who smokes ends up using heroin or cocaine, but tobacco is the first substance with which they come into contact. If we managed to prevent people from starting tobacco, it is very likely that they would not start using other substances later. It is a question of risk & rdquor ;, maintains the specialist. And he gives Alborada patients as an example of this: 90% of those who come for addiction to cocaine and heroin smoke tobacco.

For his part, Dr. Augustine Montes, Professor in the Department of Preventive Medicine and Public Health at USC, stresses the need to reinforce smoking cessation treatments.

The expert adds that the drugs currently used in smoking cessation are intended to alleviate or cancel the smoking withdrawal syndrome. “That is why they are only indicated (and financed) in those smokers who have a high physical dependence on nicotine. A drug by itself cannot make a person adopt a positive lifestyle with regard to their health& rdquor;, maintains Dr. Montes.