“Here we go for the first generation without tobacco,” tweeted the Minister of Health, Mónica García, on the eve of World Anti-Tobacco Day, celebrated on May 31. The idea of ridding an entire generation of addiction is the goal sought by a society to completely rid itself of tobacco. That those who come cannot try it and therefore cannot become addicted. To reach this peak, some governments take more radical measures than others. The United Kingdom has half as many smokers as Spain (13%) and is the first country to ban smoking, from 2027, for all people born from 2009. Ireland will raise the Legal smoking age 18 to 21.
Spain is also taking action. Once a member of the group of countries on the front line in the fight against the epidemic, he has started marching again to approve a new plan which will include – if a fragmented and deeply polarized Parliament allows – measures already explored in other countries, such as plain packaging or banning smoking in outdoor spaces. There is one, who has played a more timid role in the political debate which has taken place until now, which nevertheless envisages the most difficult problem to resolve: the equation of new tobacco products, on which the he industry counts for its survival, along with traditional cigarettes. In other words, vaping devices – with or without nicotine – are subject to the same limitations as cigarettes.
The latter are already experiencing much less success with adolescents in Spain. The percentage of students aged 14 to 18 who smoke daily fell from 23.5% to 7.5% between 1996 and 2023. And the proportion of those who have ever tried cigarettes was cut in half (from 66 .4% to 33.4%) in the last three decades. “The industry knows that if you have not consumed before the age of 18, you are not at risk of becoming dependent and that does them a lot of harm,” explains Noa Rey, community pharmacist from Ferrol and secretary of the National Committee for prevention. of Tobacco (CNPT) in certain conferences organized by the Ministry of Health this week.
However, the consumption of electronic cigarettes has not seen the same decline. Quite the contrary. 54.6% of adolescents admit to having tried them, a percentage which was only 17% ten years ago. This figure has never been so high, warns the Estudes survey, which also draws attention to the youngest boys and girls. At age 13, 14.5% of students have already used these devices; with 12.7.65%. The Department of Health does not offer data on how many vape daily.
How can we explain this diametrically opposed evolution? “I see him in the office every week. The feeling of risk is low due to the attractive and fun advertising, the references who use them (singers, actors and models), because it does not smell bad… It seems like it is harmless and it is not the case”, explains the pulmonologist. Laura Rodríguez Pons, from the German i Trias Hospital and member of the Barcelona Respiratory Network (BRN) group. 38.8% of adolescents who study high school think that vaping sporadically harms their health, according to Studies. In 2019, there were even fewer, 18.3%.
The World Health Organization (WHO) has just released a report that seeks to dismantle the industry’s strategies to “engage the next generation of consumers”, and speaks precisely to all the reasons that Dr. Rodríguez Pons is referring to: “Products with flavors and designs suitable for children” – according to a study analyzing items on the Dutch market, only 12% of them were tobacco flavored – “marketed in digital spaces” and “supported by influencers and celebrities. “The industry is working to reach children and young people to replace customers who leave or die,” the document states.
TikTok speaks well of vapers
96% of content posted on TikTok by influencers The majority of the Spanish public presents vaping as something positive, according to a study presented Friday by the Spanish Association Against Cancer (AECC). The research analyzed 154 profiles – with an average of 56,000 followers – and more than 1,200 pieces of content over a two-year period to “calibrate the impact” they have on the population between 18 and 24 years old.
The majority of content uses a leisure-oriented approach (68%), followed by those with a clear commercial intention (26%). Furthermore, “in 89% of cases, the device is clearly visible,” underlines the study. The AECC had already warned, following the results of a 2023 survey, about the consequences of this normalization: nearly 60% of young people believe that smoking is fashionable because it is done through bannersthe actors and influencers.
Among the industry’s tactics, the WHO also identifies the following: “minimizing perceptions of dependence and potential health risks”, “opposing regulation that reduces the demand for tobacco and nicotine products, including among young people” and “carrying out corporate social responsibility actions”. so that young people have a more positive perception of the industry. For some doctors, like Rodrigo Córdoba, member of the Working Group on Tobacco Control of the Spanish Society of Family and Community Medicine (Semfyc), there is even “scientific manipulation”.
Most young people do not use electronic cigarettes to quit smoking. Only two in ten between 15 and 24 years old who vape do so to quit smoking.
It is proven that the quantity of toxic components to which the person is exposed is less with electronic cigarettes or heated tobacco “because they do not burn the tobacco” (there is no combustion), according to a new guide distributed by Semfyc for monitoring. composed of patients who wish to quit smoking. However, “these lower levels do not necessarily correspond to safety” and there are other components (such as flavorings, glycerin or propylene glycol) which “may be dangerous to health”. The argument of the tobacco companies, who want to push to integrate the transition from cigarettes to vaping into public policies, is based on the fact that it is better for smokers to do less harm to themselves.
Semfyc points out that even if what we know to date is that these devices are “less harmful” in the “short term”, the “health effects of their long-term consumption are uncertain”. And above all that “they are not an approved product for stopping smoking”. Based on this idea, the United Kingdom integrated these items into its health system as part of a harm reduction program and in 2023 distributed to smokers a vaping starter kit as well as aid materials for quit traditional tobacco. Less than a year later, the British government banned disposable devices, widely used in the country, particularly by young people.
Controversial harm reduction
Harm reduction is a concept widely used in the world of addictions and is based on controlled consumption so that the impact is less, avoiding withdrawal symptoms and paving the way for stopping substance use. However, among health workers who work on tobacco dependence, there is a feeling that “the concept has been misused in one way or another”, explains Noa Rey, who points out that this is not the first time this has happened. “When filter cigarettes appeared, the prevalence of different types of cancer decreased. Then the perception of risk decreased and more people started smoking. “It could happen to us again.”
The Ministry of Health was clear on this subject in a report written in 2022: its use as a risk reduction strategy “is due more to a commercial strategy of the industry for the sale of these products than to a policy of population-based public health. “”. For this reason, he continues, “from a health point of view, the use of electronic cigarettes cannot be recommended while there are other alternatives whose effectiveness has been scientifically proven to stop smoking.” . Next June, Spain will begin financing a third drug for this purpose.
Most young people do not use electronic cigarettes to quit smoking. Only two in ten between 15 and 24 years old who vape do so to stop smoking, reveals the latest Ages survey, similar to Estudes but with a wider age range. Among older people, the percentage of consumers with this objective is much higher: 65% for the 45 to 54 age group.
If you smoke cigarettes you start from the fifth, if you vape from the fourth and when double smoking you start from the sixth.
Rodrigo Córdoba (Semfyc)
“The industry that created a problem is not the one that will help solve it. In the same way that we would not trust the Camorra to solve the mafia problem, we should not trust the tobacco industry to solve the problems of smoking,” said the Secretary of State for Health, Javier Padilla, during the conference organized by the ministry under the title Protecting young people from tobaccoin which the risks of “double consumption” were also warned. In other words, people who start vapers but they don’t stop smoking. “If you smoke cigarettes you start from the fifth, if you vape from the fourth and in case of double consumption you start from the sixth,” said doctor Rodrigo Córdoba, from Semfyc, on this forum.
Many doubts remain about the effects of the new devices, because there is no possibility of analyzing them over time. In Spain, their marketing began in 2016, but currently tobacco companies continue to increase the share of their revenues coming from what they call “smoke-free products”. The Spanish subsidiary of Philip Morris – maker of brands such as Marlboro, Chesterfield and L&M – has linked a small part of its 2022 turnover to these items. Although in reports it is classified as “other”, the company sells low temperature tobacco. in Spain. the Iqos brand. Vapes, for the moment, no.
But it is not one of the countries where the company is most established, far from it. Non-cigarette products represent more than half of the money made in 25 markets, according to the latest results presented in 2023. The tobacco company has aimed for 2030 so that only a third of what it makes comes from traditional cigarettes. “It is important that businesses take action, but without government collaboration, progress will never be as rapid as possible,” said a senior Philip Morris International (PMI) official in offering the data. In 2022, the company has broken the turnover record in Spain since 2009.
