PUBLIC HEALTH

The smoking toll in Spain: 166 men and 40 women die every day

Researchers want more proactive policies such as price hikes and more explicit warnings But so far they have seen little interest from the government of Mariano Rajoy

Smoking continues to kill tens of thousands of people a year in Spain.
Smoking continues to kill tens of thousands of people a year in Spain.Hugo Ortuno/EFE

Smoking kills more people in Spain than AIDS, alcohol, illegal drugs and traffic accidents combined.

In what amounts to a slow collective suicide, smoking-related conditions sent nearly 60,500 Spaniards to their graves in 2012 – an average of 166 men and 40 women a day – according to a new study.

A report on premature mortality led by Eduardo Gutiérrez Abejón, of the Castilla y León regional health office, has found that over 15 percent of all deaths in Spain are attributable to tobacco.

The central government has dropped the media campaigns raising awareness about how bad smoking is for you. They are expensive, but it’s money well spent”

Esteve Fernández, Spanish Epidemiology Society

“We have yet to reach the maximum level of negative effects on health,” explains Gutiérrez Abejón. His study, which was published in the journal Medicina Clínica, shows a paradox: while tobacco consumption is dropping, mortality rates are rising.

In 1998, 36 percent of people over 16 years of age were daily smokers. In 2012, the last year for which figures are available, this rate was down to 24 percent.

Yet smoking-related deaths in 1998 were estimated at 55,600, which is actually 5,000 fewer than in 2012.

Gutiérrez Abejón says this rise in mortality is explained by the female population’s relatively recent adoption of the smoking habit. In 1998, women only represented eight percent of tobacco-related deaths. Now, they make up one in every four. “This is the result of tobacco companies’ marketing campaigns,” says the researcher.

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The study also shows that half of the deaths occur among 35- to 70-year-olds.

Tobacco is linked to more than 25 diseases, but the biggest causes of death are trachea, bronchial and lung cancers, which account for more than 30 percent of smoking-related deaths. Chronic obstructive pulmonary disease makes up a further 22 percent.

Bad as it may sound, Esteve Fernández, president of the Spanish Epidemiology Society, believes that the new study actually underestimates the effects of smoking in Spain. This is because the research fails to include other diseases that have also recently been linked to tobacco, such as breast and colon cancer, and diabetes. It also does not take passive smoking into account.

More courage required

Fernández is asking health authorities for “more courage” in taking action against this legal drug, and advocating measures such as price hikes, generic packaging that does not display brand names, and the incorporation of more unpleasant images and warning labels on each pack.

“The central government has dropped the media campaigns raising awareness about how bad smoking is for you. They are expensive, but it’s money well spent,” adds Fernández, who is also director of the smoking control unit at the Catalan Cancer Institute.

In 2006 and 2011, the Socialist administration of José Luis Rodríguez Zapatero passed two laws that banned smoking first in the workplace, then in all public establishments.

But the government of Mariano Rajoy, a self-declared “inveterate smoker” of cigars, has been softer on tobacco.

Then-Interior Minister Mariano Rajoy lights a cigar at an official event in 2001.
Then-Interior Minister Mariano Rajoy lights a cigar at an official event in 2001.Gorka Lejarcegi

In 2013, when the conservative prime minister was toying with the notion of watering down the smoking ban to lure the EuroVegas casino project to Spain, nearly 40 researchers from universities such as Harvard and Berkeley told Rajoy that it was their “scientific duty” to warn him that undoing the anti-smoking law “would be a senseless initiative with negative long-term effects on Spain’s health and economy.”

When Rajoy was public administration minister between 1996 and 1999, he stated that smoking was a virtue rather than a vice, and boasted about how he personally ignored anti-smoking rules. At a meeting of the Fiscal and Financial Policy Council, “the Andalusian government’s economy chief showed up with a decree that banned smoking, but I noted that the mandatory signs were not up on the wall, and I smoked one of my cigars,” he told magazine El Fumador (The smoker).

“In view of our results, it’s clear that awareness policies are insufficient,” concludes Gutiérrez Abejón.

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