Spain bans painkiller for tourists after death of ten Brits

Spanish health authorities have banned the sale of a common painkiller to tourists after it was linked to the deaths of at least ten British holidaymakers.

Spain bans painkiller for tourists after death of ten Brits

Spain’s Agency of Medicines and Medical Devices (AEMPS) has updated its guidelines for the drug Nolotil warning against it being prescribed to those visiting Spain for a short time.

“The drug should only be prescribed for short-term treatments, seven days at the most and should be avoided long term if it is not possible to monitor the patients' white cell count with regular blood tests,” said the statement from AEMPS.

The warning also advised “special precaution with patients of advanced age” because they were more vulnerable to infection. 

The warning effectively means a ban on prescribing the drugs to visitors and came about following a campaign by Cristina Garcia del Campo, a medical translator in Alicante, who lobbied for an inquiry after she discovered the link between a number of British and Irish tourists who suffered blood poisoning when prescribed the drug.

“I feel very happy about the recommendations issued by the AEMPS,” Garcia del Campo told The Local.  “If these recommendations are strictly followed by doctors and chemists, I will be satisfied, otherwise, I will continue to work until they are,or the problem is solved, whatever it takes.”

An investigation by the drug regulator confirmed that at least ten people prescribed Nolotil while visiting Spain had died from blood poisoning after contracting agranulosis (also known as granulopenia) – an acute condition caused by a severe lowering of the white blood cell count.

The drug has not been licensed for use in the USA, Britain and Sweden but is widely prescribed in Spain.

The drug's prospectus claims that agranulocytosis is a “very rare” side effect that could occur in one in 10,000 patients, the AEMPS found that maybe more frequent among Britons due to a possible “genetic peculiarity”.

Boehringer Ingelheim, the manufacturer of Nolotil, said the drug is available in many generic forms in Spain and other European countries and there is no scientific evidence that specific populations are prone to develop side effects.


How Spain could stamp out smoking

A fifth of Spain's population smokes on a daily basis. With such high numbers, here's how the country's pulmonologists propose to get smokers to quit.

Spain plans to get people to quit smoking
How Spain plans to get people to stop smoking. Photo: Khalil MAZRAAWI / AFP

For many outsiders, Spain is a nation of smokers. 

The stats from Spain’s Ministry of Health show that 23.3 percent of men smoke every day in Spain, compared with 16.4 percent of women.

For both males and females, the highest number of smokers are aged between 25 and 34, meaning that it’s the younger population who are smoking slightly more than the older generations. 

Spain’s pulmonologists are now pushing for the country’s tobacco laws to be tightened, claiming that reform is needed after the last legislation was approved a decade ago.

READ ALSO: Spain warns against smoking and vaping in public to avoid Covid infections

Why is smoking such a problem in Spain and what is being done about it?

The latest stats from the Spanish Ministry of Health show that lung cancer, often caused by smoking, is the third most frequently diagnosed cancer in Spain, with 29,549 cases diagnosed so far in 2021.

Given these high figures Spain’s Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has proposed five measures to help get people to stop smoking.

SEPAR points out that every time anti-smoking legislation is reformed and things for smokers made more difficult, the prevalence of smoking decreases.  

Smoking on terraces was banned in some regions during the pandemic. Photo: CRISTINA QUICLER / AFP
  • Price of tobacco to rise in 2022

The first point on their list is to raise the price of tobacco, which must cover all forms, from cigarettes to cigars, through to rolling tobacco, and electronic cigarettes.  

This first measure may soon become a reality as the Spanish government has already predicted that the price of tobacco will rise in 2022, after several years of stagnation.  

It is expected that tobacco will be responsible for almost a third of all special taxes received in 2022, equating to €21.8 billion.

According to the World Health Organization (WHO), “cheap tobacco” in Spain guarantees “a percentage of smokers above 30 percent”.

In Spain, the price of a pack of tobacco is around €5, which is much cheaper than in other countries. In Australia for example, a pack of tobacco costs around €22, and in the United Kingdom and France, each pack of tobacco costs around €12.4 and €10.5, respectively.

According to Dr. Carlos A. Jiménez Ruiz, pulmonologist and president of the society, the current anti-smoking law has “some deficiencies” that need to be addressed in order to develop legislation that is more effective and efficient, especially with regard to the prevention of tobacco consumption in young people, but also in helping smokers to stop smoking and in protecting the health of non-smokers. 

READ ALSO – Maps: Which beaches in Spain have banned smoking?

Besides increasing the cost of tobacco SEPAR proposes four other measures to get Spain to quit smoking. These include:

  • Banning the consumption of tobacco in public spaces, even outdoors
    During the pandemic, several regions approved a regulation to prohibit smoking on terraces. SEPAR proposes that smoking be prohibited not only in spaces such as terraces but also in sports stadiums, beaches, parks and bullrings, and that fines should be imposed for those who do not comply.

  • Establish generic packaging
    SEPAR also wants Spain to introduce generic packaging, which means no logos and images of the tobacco companies. This measure has also proven to lower the sales of tobacco in countries where it has been implemented, such as Australia and New Zealand. According to the latest statistics from the Australian National Drug Strategy Household Survey around 11.6 percent of adults in Australia smoke daily. 

  • The regulation of other smoking devices
    Despite the fact that all products that burn tobacco such as cigarettes are already regulated, SEPAR believes that it is also necessary to regulate the sale, consumption and advertising of electronic cigarettes. This is because e-cigarettes have become particularly popular among young people. 

  • Promote help for those seeking to quit smoking
    The last proposal is the creation and development of special units in public health departments to help people to stop smoking and to put more funds towards these programmes. 

How does Spain compare with other European countries when it comes to smoking?

According to the Organisation for Economic Cooperation and Development (OECD), while Spain does have a high number of smokers there are still several European countries that have more. The European countries with the highest number of smokers are Greece, Bulgaria and Hungary.

The latest European survey from 2020 shows that 42 percent of Greeks claim to be smokers, which is only slightly above Spain. 

On the other side, the European countries with the lowest number of smokers are mainly Nordic countries, such as Sweden, Finland, Iceland and Norway.