Aser García Rada, Madrid
The Spanish law banning smoking in all public premises since January 2010 has become one of the greatest national public health achievements in decades. It modified a previous law from 2006 that banned smoking in enclosed working environments but allowed it in certain bars and restaurants. The tobacco lobby fought strongly against this change as they were interested in exporting what was known as “the Spanish model”: allowing smoking in places of entertainment maintained the social acceptance of a drug that kills 700,000 Europeans annually. To Big Tobacco´s dismay, the 2010 model soon spread to other countries.
According to the Spanish National Institute of Statistics, smoking prevalence has decreased from 26.2% in 2006 to 23.95% in 2012, the lowest rate in 25 years. Heart attacks have dropped by 11% after the 2006 legislation was established, so further drops are expected from 2010 on. The EU Commission has stated that Spain has experienced the largest decrease in passive smoking of the EU over the last years: 70% less, well above the EU average of 46%. In addition, 82% of the population –including many smokers- agree with current legislation, says a poll by the Spanish Society of Family and Community Medicine (SEMFYC). In fact, social acceptance is increasing, according to the last health barometer of the Ministry of Health, Social Services and Equality.
The current law has only been weakened once. It was done by the previous social democrat Government of Jose Luis Rodriguez Zapatero following pressure from the largest Spanish department Store El Corte Inglés to allow the sale of smoking products in convenience stores such as their Opencor chain. Now Sheldon Adelson, Las Vegas Sands casino chairman, 12th on the Forbes 400 list of the richest Americans and one of the most important magnates of the gambling industry, has announced the construction of the largest casino resort in Europe in the autonomous community of Madrid, a project popularly known as Eurovegas. Adelson, whose company is under criminal investigation for possible violations of the U.S. Foreign Corrupt Practices Act, and has just agreed to pay $47 million to the U.S. to settle a money-laundering case, has requested that Spain’s smokefree law be weakened to allow smoking in the casino’s premises. He promises that the casino project will create 200,000 jobs and bring prosperity to the region.
Thus, the regional and national governments are salivating. Amendments to labor and urban planning laws and tax breaks have already been negotiated. The repeated requests from the president of the autonomous community of Madrid, Ignacio González, from the conservative People´s Party (PP), that the central government amends the law seem to be having their effect. Recently the minister of health, social services and equality, Ana Mato, also from the PP, said that the Government is “looking for ways” to “reconcile the protection of health with the creation of jobs”. In fact, according to the newspaper El Mundo, the change has already been decided: smoking will be allowed in certain areas on all current 41 casinos throughout the country and on those to be built in Eurovegas. The daily La Razón states that the law will be amended before November.
The EU Commission considers that the economic impact of banning smoking across the EU has been limited, neutral and even positive in bars and restaurants industry except for maybe on gambling premises, a probably correct estimate according to the available scientific literature. However, the comorbidity between tobacco smoking and gambling seems clear. Tobacco might have neurochemical effects that enhance gambling behaviour (1) and problem gambling severity and amount of money spent, have been related to smoking (2). Must we create further death and disease to have jobs?
Health professionals are fighting the change and the global community is watching. An umbrella platform of different tobacco control organizations (porquenosotrosno.org) has launched the campaign Don´t touch the law to request international support to prevent the weakening of these public health protections. But the tobacco lobby´s tentacles remain long. The presidents of five autonomous communities in which tobacco is cultivated –Extremadura, Andalusia, La Rioja, the Canary Islands and Cantabria- recently signed a document opposing the new stronger Directive on tobacco control under discussion at the EU during a joint meeting celebrated in the headquarters of the tobacco company Altadis. Meanwhile, according to members of the Directorate General for Health & Consumers of the European Commission, there is a growing concern that former health commissioner John Dalli’s resignation may have been related to Big Tobacco’s strategies.
Health workers and other citizens must be aware of these manoeuvres and press health authorities at all levels that no concessions must be given to tobacco companies or others whose interests in profit threaten public health.
References:
1.- Mcgrath, DS and Barret, SP (2009), The comorbidity of tobacco smoking and gambling: A review of the literature. Drug and Alcohol Review, 28: 676–681. doi: 10.1111/j.1465-3362.2009.00097.x
2.- McGrath DS, Barrett SP, Stewart SH, and McGrath PR. A Comparison of Gambling Behavior, Problem Gambling Indices, and Reasons for Gambling Among Smokers and Nonsmokers Who Gamble: Evidence from a Provincial Gambling Prevalence Study Nicotine Tob Res (2012) 14 (7): 833-839