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HEALTH

EXPLAINED: Spain’s plans to ban smoking on bar terraces

On World No-Tobacco Day, discussions about banning smoking on all bar and restaurant terraces in Spain are heating up, with legislation set to be approved in the coming year.

SPAIN-HEALTH-VIRUS-SMOKING
A man smokes while drinking beer with friends at the terrace of a bar in Sevilla on August 13, 2020.(Photo by CRISTINA QUICLER / AFP)

It’s one of the most common sights in Spain: a busy bar terrace with friends and families sat around tables enjoying food and drinks outdoors, while a handful of smokers light up cigarettes and puff to their hearts’ content. But it may not be long before this scene is no longer played out.

Spain was in fact one of the first countries to adopt a strict smoke-free provision with a complete ban on smoking in enclosed public spaces, public transport, and workspaces – with only limited exceptions allowed.

The changes, first set in the Anti-Tobacco Law of 2005 but significantly increased by 2010, when all restaurants and bars became non-smoking places, came amid low public support.

In 2009, 51 percent of Spain’s population was completely in favour of smoking restrictions in restaurants, below the EU average of 63 percent.

Back then, 31.5 percent of the Spanish said they smoked (cigarettes, cigars or a pipe) every day or occasionally, and 19.7 percent said they used to smoke but stopped.

Just about a decade later, the numbers have changed: 24 percent of the population says they currently smoke, according to a European Commission research, and 31 percent replied that they used to smoke but have stopped.

This seems to be directly related to an array of measures and changes in public perception of smoking, and studies have shown that places with smoking bans have lower numbers of smokers.

What is the current law on smoking in Spain?

For a decade, Spain has had a complete ban on smoking in enclosed public spaces, public transport, and workplaces.

Since 2010, it’s been only allowed to smoke outdoors in the open air in Spain, “in every space that is not covered, or every space that, despite coverage, is surrounded on its side by a maximum of two walls”.

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

Despite the lowering numbers, Spain also has too many smokers, pulmonologists warn. And the consequences are severe: lung cancer, often caused by smoking, is the third most frequently diagnosed cancer in Spain, according to the Spanish Ministry of Health.

Given these high figures, Spain’s Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has already proposed measures to help people stop smoking, including a ban on tobacco consumption in public spaces, even outdoors.

What will the Spanish government do?

Spain’s government is working on a plan to reduce tobacco consumption by 2025, following a target by the World Health Organisation (WHO) to cut by 30 percent the consumption of tobacco by 2025, compared with data from 2010.

READ ALSO: How Spain could stamp out smoking

Among the measures is a total ban on smoking in open-air places where many people meet, such as the terrazas (bar, cafe, restaurant terraces) and beaches.

Some private spaces, including cars, could also become non-smoking areas.

Other measures include changes in the packaging of cigarettes to become “neutral”, without logos or colours, and an increase in cigarette prices.

When are the changes coming?

The proposed smoking laws announced by the Health Ministry, which were expected to come into force in 2021, are still delayed.

The package of new measures can only be ready by late 2022 or early 2023 as they must first have the approval of the Public Health Commission of Spain’s Interterritorial Health Council, before reaching the Spanish Cabinet and Parliament.

Successive health emergencies – from the coronavirus pandemic to recent cases of child hepatitis and monkeypox – have delayed the plans.

Though there is not even full agreement on how to implement which measures. For example, a smoking ban on private cars could come only when children or pregnant women are inside vehicles.

READ ALSO: Spain set to offer 100% paid week-long leave to care for family members

The Health Ministry says that the text is “practically ready” but still not approved as there are still “small administrative matters” that need to be solved, according to online daily 20minutos.

“We cannot wait any longer”

In the meantime, health associations, including the Spanish Society of Family and Community Medicine (semFYC), ask the government to speed up.

“In Spain, we are already far behind other European countries regarding measures to prevent smoking. These measures are designed to protect the health of the population and even the environment. That is why we consider that changes such as the extension of smoke-free spaces to terraces and our beaches and neutral tobacco packaging are measures that in Spain we cannot wait any longer”, says semFYC representative Susana Morena.

READ ALSO: Smoking near kids is ‘form of abuse’: Spanish experts

Spain’s Cancer Association (AECC) highlights that the measures would significantly protect young people and all populations by reducing risk factors that can cause cancer.

According to data from AECC, in 95 percent of the terraces in Spain, traces of damaging substances in tobacco can be found.

The same is true in 46 percent of schools access areas or 43 percent of playgrounds, the Cancer Association says. Moreover, a burnt-out cigarette butt continues to give off 14 percent nicotine for at least 24 hours, they added.

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BREXIT

Reciprocal healthcare agreements between Spain and Gibraltar end

The Spanish government has confirmed that it will not extend its reciprocal healthcare agreements with Gibraltar, meaning that from July 1st 2022, it will come to an end.

Reciprocal healthcare agreements between Spain and Gibraltar end

When the UK left the EU on December 31st 2020, both sides agreed that the UK’s EHIC European healthcare cards could still be used until their expiry dates.

This card provided British travellers with free state-provided medical care in the EU in case of emergencies.

Beyond their five year period of validity, EHIC cards are no longer valid and travellers have to apply for the new Global Heath Insurance Card (GHIC) instead. 

Spain made a separate agreement with Gibraltar under its Royal Brexit Decree in which unilateral arrangements would be maintained in the territory and extended until June 30th 2022.

During the meeting of the Spanish Council of Ministers on Tuesday, the Spanish Government decided not to extend the agreement further, meaning that residents of Gibraltar will no longer be able to benefit from it.

In a statement the government of Gibraltar said: “It would have been HMGoG’s preference for these arrangements, which deeply affect citizens on either side of the border on matters as essential as healthcare, to have been maintained. Indeed, HMGoG was prepared to continue with them”.

“However, because reciprocity is a key element to these arrangements which cannot work without coordination and provisions for reimbursement of costs etc., HMGoG is left with no option but to discontinue them also in so far as treatment in Gibraltar is concerned,” it continued. 

What does this mean?

Gibraltar residents insured under Gibraltar’s Group Practice Medical Scheme will, after 30th June 2022, no longer be able to access free emergency healthcare in Spain during a temporary stay in the country. 

Those who are residents in Spain who travel over to Gibraltar will not have access to free healthcare on The Rock either. 

As a consequence, if a resident of Gibraltar falls ill or has an accident while over the border in Spain or the same for a Spanish resident in Gibraltar, they will have to pay for healthcare.

The government of Gibraltar is encouraging its citizens from July 1st 2022 to have appropriate travel insurance with medical cover each time they visit Spain.

This means that even those who are hopping over the border for few hours such as for a shopping trip or going out for dinner will have to make sure that they have adequate health insurance. 

“Where medical attention is required the costs incurred may be considerable, so you should ensure you have adequate insurance cover or alternatively the means to pay,” the Gibraltar government said in their statement.

  

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