Health approves the anti-smoking plan with the support of the communities after the turn of the PP councilors

The new Comprehensive Plan for the Prevention and Control of Smoking 2024-2027, the national strategy that aims, among other things, to expand smoke-free spaces, raise taxes and expand smoking cessation plans, went ahead this Friday with the consensus of the Ministry of Health and communities. Finally, the autonomies have given their approval after several weeks of a tense debate between the administrations. Only four had adhered to the strategy just 24 hours before the meeting of the Interterritorial Council of the National Health System (CISNS) this Friday: Catalonia, the Canary Islands, Navarra and Asturias.

The rest had refused to join and had shown their reluctance towards a procedure that, just as the Health Ministry had proposed, they did not share: in principle it was a cooperation agreement between the communities that will mark the strategic lines against tobacco for the coming years and at the same time that they could adhere to all or part of that strategy. However, as reported by Minister Mónica García after the meeting, there has been a change in the procedure at the last minute and it has become a point that has been reported within the CISNS, something that does not require a vote or accessions.

The communities that had not joined shared, above all, two discrepancies: the lack of economic memory of the plan and the absence of concreteness when it talks about expanding smoke-free spaces. Some were also against the generic packaging of packs, which consists of no distinction between brands and a measure that has been shown to be an effective formula to reduce smoking.

Although there have been no changes to the text in the last few hours, the PP communities have changed their position due to two commitments that, according to them, Health has acquired: the first, that part of what is collected with the foreseeable tax increase will have repercussions in the fight against tobacco. It was an aspect that in principle Health did not accept, since the final taxes have a complicated technical fit and also because the ministry expects that collection will decrease due to the decrease in consumption.

Luis García Comesaña, counselor of Galicia and who has acted as spokesperson for the popular communities, has also indicated that the ministry has committed to discussing with them in the legislative process what the smoke-free spaces will be, and that they will not limit themselves to prohibiting, but also include recommendations. This is something that does not change the plan at all, since it did not specify what those places would be.

The Minister of Health explained that a good part of the meeting focused precisely on how these spaces will be decided. As planned, it will be her department that will make a legislative proposal, which will have to go through Congress, receive amendments and be agreed upon by a majority of deputies.

Change of posture

These two nuances, which do not affect the text, have served to change the position of the opposing communities, after a beginning of the meeting that some of the participants described as tremendously tense. As the hours passed, the popular councilors (those most contrary to the norm) have changed their position. To the point that Comesaña has described the day as “important for the fight against tobacco.” “Of course, the PP communities are satisfied that the plan includes everything it includes,” he expressed at the end of the meeting.

In the last few hours, several associations that work in the fight against tobacco, such as the Spanish Association Against Cancer or the National Committee for the Prevention of Smoking, had addressed popular communities to support the plan. Institutions such as the General Nursing Council had also done so.

In Health they believe that the final support shows that the disagreements exhibited until now responded more to a political strategy than technical aspects. Not in vain, a large majority of the plan was already shared by all the actors. There was agreement on the major objectives set out in the document, which was written in a first draft together with the communities' own technicians and then reviewed by their Public Health directors. They made a total of 157 allegations, of which all but 10 were accepted.

These five shared pillars are: preventing the initiation of the use of tobacco and related products, promoting smoking cessation and facilitating help to quit smoking, reducing environmental exposure to emissions from tobacco and related products, promoting applied research and monitoring tobacco control and enhancing coordination and establishing alliances.

“We have the firm intention of once again putting Spain at the forefront of the battle against smoking, with an ambitious plan with all the dialogue mechanisms so that it is a plan of the Ministry with the communities. Today, this achievement is a source of pride, the result of the commitment of society, scientific societies, citizen groups, health professionals,” García listed, who thanked “all the autonomous communities” that have “prepared the document for a long time”.

“We have laid the foundations for the following advances in legislative matters. Among other things, we must talk about equating new forms of smoking with traditional tobacco, with tobacco taxation. The plan has a part to increase smoke-free spaces to guarantee the right to breathe. For this reason, this entire part will be transferred to legislative initiatives that offer legal security and development in the legislative space,” continued the minister, who preferred not to detail which spaces her department will propose as smoke-free. .

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