“It is difficult to imagine what the real intentions of the government will be,” Carmen Escrig told Filter.
She was commenting on a recent public consultation over Spain’s tobacco products law (28/2005). The Ministry of Health intends to amend the law, which regulates sale, supply, consumption and advertising, in order to “combat smoking.” The consultation opened in July and closed on August 15.
Advocates like Dr. Escrig, who has a PhD in molecular biology and is based in Madrid, have reason to fear that not only cigarettes but vapes and other safer nicotine products will be in the crosshairs.
“They opened the public consultation with a vague document from which we can infer that they want to regulate consumption in public places, advertising and points of sale, but we do not know how,” explained Escrig, who is the founder and coordinator of the group Spanish Medical Platform for Tobacco Harm Reduction.
Though the document is ambiguous, it angles toward treating all nicotine products equally, without considering their relative levels of risk. Part of it, titled “Objective of the standard,” states that the government aims to introduce measures for “healthy and smoke-free spaces in community and social settings,” as well “improvements” on advertising, and “restrictions on the sale and use of electronic cigarettes with or without nicotine.”
Sweeney noted that the stated aim is to address smoking-related mortality. “However, the proposals are almost entirely focused on restricting safer nicotine products.”
Damian Sweeney, an Irish advocate and partner with the consumer advocacy group European Tobacco Harm Reduction Advocates (ETHRA), noted that the stated aim of the document is to address smoking-related mortality and morbidity.
“However, the proposals put forward are almost entirely focused on restricting noncombustible safer nicotine products, which are proven to be the most effective and popular means of smoking cessation,” he told Filter.
Any move to clamp down on vapes and other safer substitutes for cigarettes, or to disincentivize their use, would be particularly concerning in Spain. The country has one of the highest smoking rates in Europe. Escrig said that the rate has actually increased: from 32.8 percent in 2005, to 33.1 percent today.
Escrig attributes this to the “total failure” of Spanish tobacco control agencies over the past 20 years, characterized by their unwillingness to support people who cannot or do not wish to stop using nicotine. It’s been the traditional “quit or die” approach to populations who smoke.
Cigarettes are cheaper than in many other parts of Europe. You can buy a pack of 20 for less than €8, compared to about €11 in France, for instance. This, together with the absence of policies to encourage adoption of safer nicotine products, means that people who smoke have little external incentive to make the switch.
“Repeating ineffective strategies and expecting different results is absolutely inefficient … The sad thing is that this inefficiency is paid in lives.”
“Repeating the same ineffective strategies and expecting different results is absolutely inefficient and causes much suffering,” Escrig said. “The sad thing is that this inefficiency is paid in lives.”
There are about 60,000 smoking-related deaths in Spain each year.
Sweeney also cited Spain’s high smoking rate as evidence that current tobacco control policies aren’t working. “Further restrictions on [safer nicotine products] will only exacerbate the problem,” he added.
A few days before the public consultation ended, ETHRA, the European group of which both Sweeney and Spanish consumer association Anesvap are partners, sent an open letter to Spain’s Ministry of Health, expressing concern.
It stated that although the government’s consultation document correctly highlighted serious health impacts associated with smoking and second-hand smoke, it failed “to acknowledge that non-combustible nicotine products pose a small fraction of the risk of smoking.” Consumers, the letter said, “believe regulation should be risk proportionate and non-discriminatory.”
“If they do not take a courageous stand and stop repeating the mistakes of the last 20 years, the thousands of diseases and deaths will simply continue.”
But momentum seems to be in the opposite direction. In April, the Ministry of Health took the first step toward approving a decree that aims to introduce a vape flavor ban and mandate plain packaging for vaping products. ETHRA also responded to that with an open letter.
Special restrictions on vapes and their promotion, together with the notion of treating them the same as combustible tobacco in public spaces and other contexts, all add up to making these products less visible and accessible to people who smoke, Sweeney said—when knowledge and access are key to people’s likelihood of switching to alternatives that won’t kill them. He and his allies urge the Spanish government to think again.
“Science-based policies which allow a wide range of appealing, low-risk alternatives to smoking is the fastest way to reduce smoking and its related harms,” Sweeney said.
“If our government really cares about people’s lives, it should stop listening exclusively to those science denialist organizations that have failed for 20 years and have notorious interests,” Escrig concluded. “If they do not take a courageous stand and stop repeating the same mistakes of the last 20 years, the thousands of diseases and deaths caused by smoking will simply continue.”
Photograph by Miguel Madrid – Cotidiano Fotografías via Flickr/Creative Commons 2.0
Correction, August 28: This article has been edited to correct the Spanish smoking rate given for 2005, which was originally misstated as a higher figure.