Spain’s rising female cancer deaths spark warning over nicotine pouch ban

MADRID – New research exposing an alarming rise in lung cancer mortality among Spanish women has triggered fierce criticism of Spain’s proposed ban on oral nicotine pouches, with international health experts warning that the move will lock women into smoking and result in thousands of preventable deaths.

EU-wide analysis shows Spain stands apart from most European countries, where female lung cancer mortality is stabilising. In Spain, deaths among women are projected to rise by 2.4% through 2026, reaching around 10 per 100,000 – a stark signal that current tobacco control measures are failing women.

“These statistics represent mothers, daughters and working women whose lives could still be saved,” said Dr Delon Human, Smoke Free Sweden leader and former secretary-general of the World Medical Association.

“Spain’s experience proves that traditional tobacco control alone is no longer enough. The countries making real progress are those that actively support safer, smoke-free alternatives that people actually use. Real-world evidence shows nicotine pouches are among the most effective quitting tools, especially for women.”

In 2023 alone, 49,510 deaths in Spain were attributed to tobacco use. Despite decades of traditional tobacco control measures, adult smoking remains stubbornly high at around 25.8%, including 22.6% of women.

After peaking at 30.8% between 2007 and 2015, daily smoking only began to decline following the emergence of safer nicotine alternatives. Now, proposed regulations threaten to remove nicotine pouches from the market entirely.

“This would be a devastating step backwards,” Dr Human said. “At precisely the moment Spain needs innovation, it is choosing prohibition.”

In Sweden, widespread access to smoke-free alternatives, including nicotine pouches, has helped drive female smoking rates to the lowest in Europe, putting the country on track to become the world’s first smoke-free nation, with adult daily smoking prevalence below 5%.

Smoke Free Sweden is urging Spanish policymakers to adopt risk-proportionate regulation that clearly distinguishes deadly combustible cigarettes from safer smoke-free alternatives.

“If Spain wants to reverse the rising tide of lung cancer among women, it must follow the evidence,” Dr Human said. “The countries winning against smoking are not banning innovation, they’re embracing it.”

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