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      Luces y sombras para la salud pública: análisis crítico de la legislación sobre el tabaco en España Translated title: Lights and shadows for public health: a critical analysis of the tobacco legislation in Spain

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          Abstract

          Resumen El tabaquismo es una enfermedad crónica que constituye la primera causa evitable de muerte en los países desarrollados. En España, la prevalencia de consumo de tabaco ha disminuido gracias a la aplicación de políticas de control del tabaco; sin embargo, la legislación vigente no establece una regulación armonizada para todos los productos. El objetivo de este artículo es revisar la legislación actual y analizar sus limitaciones en relación con los principios de buena regulación administrativa definidos ahora en la Ley 39/2015. Las principales limitaciones pueden vertebrarse en cuatro ejes: la falta de regulación específica de estos nuevos productos, las diferencias en su regulación, la falta de información de sus efectos nocivos y de las novedades en la regulación de los espacios libres de humo, y la falta de adaptación de la regulación a la evidencia científica más reciente. Con todo, la calidad de la regulación para el control del tabaco en España, pese a los éxitos conseguidos con la Ley 28/2005, se ha visto comprometida por la relajación del Estado en el ámbito legislativo, regulatorio y administrativo, que ha comportado un estancamiento normativo opuesto a los principios de buena regulación. Esta revisión debería animar a las sociedades científicas y las asociaciones ciudadanas a reclamar igualmente la modernización de la legislación sobre tabaquismo, con políticas decididas y coordinadas de prevención y control para poder promover una España libre de tabaco.

          Translated abstract

          Abstract Tobacco smoking is a chronic disease that is the leading preventable cause of death in developed countries. In Spain, the prevalence of tobacco use has decreased driven by the implementation of tobacco control policies; however, current legislation does not establish a harmonized regulation for all tobacco products. The aim of this article is to review the current legislation and critically analyze its limitations in relation to the principles of good administration now defined in the Law 39/2015. Spanish in force tobacco control policies main limitations can be divided into four areas: the lack of specific regulation for new tobacco products; the differences in their regulation; the lack of information to the general population on their harmful effects and the new developments in the regulation of smoke-free spaces; and the lack of adaptation of the regulation to the most recent scientific evidence. All in all, the quality of tobacco control regulations in Spain, despite the successes achieved with the Law 28/2005, has been compromised by the State's laxity in the legislative, regulatory, and administrative spheres, which has led to a regulatory stagnation that runs counter to the principles of good regulation. This review should encourage scientific organizations and civil society associations to call for an actualization of the tobacco legislation, with determined and coordinated prevention and control policies to promote a tobacco-free Spain.

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          Most cited references18

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          Tobacco control policies in the 21st century: achievements and open challenges

          Noncommunicable diseases (NCDs), including cancer, are responsible for almost 70% of all deaths worldwide. Tobacco use is a risk factor common to most NCDs. This article discusses tobacco control policies and highlights major achievements and open challenges to reduce smoking prevalence and attributable morbidity and mortality in the 21st century. The introduction of the WHO Framework Convention on Tobacco Control in 2005 has been a key achievement in the field and has already facilitated a drop in both smoking prevalence and exposure to secondhand smoke. Indicatively, the size of the worldwide population benefiting from at least one cost‐effective tobacco control policy has quadrupled since 2007. In addition, plain cigarette packaging has been successfully introduced as a tobacco control policy, surmounting efforts of the tobacco industry to challenge this based on trade and investment law. Nevertheless, tobacco control still faces major challenges. Smoking prevalence needs to be further reduced in a rather expedited manner. Smoke‐free environments should be extended, and the use of plain tobacco packaging with large pictorial health warnings for all tobacco products should be further promoted in some parts of the world. Some of these measures will require prompt determination and diligence. For example, bold political decisions are needed to significantly increase real prices of tobacco products through excise taxes, ban added ingredients that are currently used to increase the attractiveness of tobacco products and ban the tobacco industry's corporate social responsibility initiatives. Finally, the debate on harm reduction strategies for tobacco control still needs to be resolved.
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            PMI’s heated tobacco products marketing claims of reduced risk and reduced exposure may entice youth to try and continue using these products

            Philip Morris International (PMI) is seeking Food and Drug Administration’s (FDA) authorisation to market IQOS as a modified risk tobacco product and to make marketing claims of reduced risk and reduced exposure. Such claims may be misunderstood by youth, thereby increasing their risk for tobacco initiation. To assess youth (mean age 19.3, SD=1.7) understanding and perceptions of PMI’s proposed consumer marketing claims of reduced risk and reduced exposure, we embedded a randomised controlled experiment into a survey of 450 California youth (April to August 2018). Participants were randomised to see ‘reduced exposure’, ‘reduced risk’ or neither claim. Perceptions of IQOS-related health risks and general harm and understanding of the term ‘switching completely’ as used in PMI’s proposed claims were compared. Mean expectancies to experience specific health risks did not differ by claim exposure. The reduced exposure group’s perceptions of general harm did not differ from those of controls nor from the reduced risk group. The reduced risk group had the largest proportion who perceived IQOS as moderately/less harmful (n=78, 52%); controls the largest proportion perceiving IQOS as quite/extremely harmful (n=91, 63%). While 71% of the sample understood the term ‘switch completely’ correctly as used in the reduced risk (n=194, 71%) and reduced exposure (n=206, 72%) claims, more than 1 in 4 did not. FDA and other regulators must use caution when considering allowing claims of reduced risk or reduced exposure to appear on retail tobacco packaging. Youth misunderstand such claims, and misperceptions of harm are known to lead to tobacco-use initiation.
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              The burden of disease in Spain: Results from the Global Burden of Disease 2016

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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                February 2022
                : 36
                : 1
                : 48-52
                Affiliations
                [3] Barcelona Cataluña orgnameUniversitat de Barcelona orgdiv1L'Hospitalet del Llobregat orgdiv2Facultad de Medicina y Ciencias de la Salud Spain
                [5] San Francisco orgnameUniversity of California orgdiv1Philip R. Lee Institute for Health Policy Studies United States
                [1] Barcelona orgnameL'Hospitalet de Llobregat orgdiv1Institut Català d'Oncologia orgdiv2Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco España
                [2] Barcelona orgnameL'Hospitalet de Llobregat orgdiv1Institut d'Investigació Biomèdica de Bellvitge-IDIBELL orgdiv2Grupo de Investigación en Control del Tabaco España
                [4] orgnameCIBER de Enfermedades Respiratorias (CIBERES) España
                Article
                S0213-91112022000100048 S0213-9111(22)03600100048
                10.1016/j.gaceta.2021.07.001
                34419288
                b2572629-4cac-4274-8a80-4029787e5eb0

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 08 July 2021
                : 07 July 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 5
                Product

                SciELO Spain

                Categories
                Artículos Especiales

                Tobacco control,Normativa,Control del tabaco,Análisis crítico,España,Legislation,Critical analysis,Spain

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