Experts warn Spain against blocking escape route for smokers

STOCKHOLM – Leading international health experts have issued a strong warning to the Spanish government over its draft tobacco bill, cautioning that equating safer nicotine alternatives with cigarettes will condemn millions of smokers to continue with their deadly habit.

In a formal submission to Spain’s Ministry of Health (Ministerio de Sanidad), the experts urged policymakers to adopt a risk-proportionate approach that distinguishes between combustible tobacco and safer alternatives such as e-cigarettes, nicotine pouches, heated tobacco products and Swedish snus.

The proposed draft bill places the same restrictions on smokeless products as conventional tobacco, including bans on public use, single-use vapes and advertising.

According to the experts, these measures could “push smokers who have successfully switched to lower-risk products back to smoking”.

“A one-size-fits-all approach to tobacco control ignores the fact that e-cigarettes, for example, are 95% less harmful than cigarettes,” said Dr. Delon Human, former Secretary-General of the World Medical Association, who is one of the signatories to the submission. “It is far better for a smoker to switch from cigarettes to e-cigarettes or nicotine pouches than to continue smoking.

“The Spanish tobacco bill risks robbing smokers of these potentially life-saving options.”

The experts pointed to Sweden’s success as a model: with smoking rates at just 5.3% – the lowest in Europe – the country has a male lung cancer death rate that is 61% lower than the EU average. Sweden’s approach, combining traditional tobacco control with harm reduction, is widely recognised as a blueprint for other EU nations.

The experts, who also include Prof. Karl Fagerström, Dr. Jacques Le Houezec, Prof. Heino Stöver, Dr. Christopher Russell, Prof. Andrzej Sobczak and Dr. Gintautas-Yuozas Kentra, stressed that harm reduction complements, rather than undermines, conventional tobacco control measures.

By broadening the options available to smokers, harm reduction strategies increase the chances of quitting smoking and reducing tobacco-related harms.

The experts also warned that prohibitionist policies could inadvertently fuel the black market and increase youth access, undermining public health goals.

Dr Human, leader of the Smoke Free Sweden movement, added: “Spain has a choice: follow the evidence and save lives like Sweden or keep smokers trapped with cigarettes, the most dangerous form of nicotine use.”