Spain is facing the abyss regarding smoking and public health. With a staggering 24 percent smoking prevalence — among the highest in Western Europe — the country has a significant public health challenge on its hands. Yet rather than embracing the innovative solutions that have dramatically reduced smoking rates in countries like Sweden, Spain under Pedro Sánchez is retreating into prohibition and regression.
The Spanish Health Ministry’s recent draft decree represents nothing short of a full-scale assault on nicotine innovation. The proposal includes a sweeping ban on all non-tobacco flavors for vaping products and nicotine pouches, alongside a draconian nicotine limit of 0.99mg per pouch — effectively a ban in all but name. This approach doesn’t just miss the mark; it actively undermines public health objectives while protecting the cigarette market.
The Swedish Miracle vs. Spanish Stagnation
Sweden’s remarkable achievement in reducing smoking to just 5.3 percent of its population — already meeting the European Union’s 2040 smoke-free target — didn’t happen by accident. The Nordic nation discovered the missing piece in the global anti-smoking puzzle: innovation in nicotine delivery.
While fully implementing traditional tobacco control measures, Sweden took the crucial additional step of recognizing that smokers need not just reasons to quit but practical, acceptable alternatives. By ensuring the accessibility, acceptability, and affordability of innovative nicotine products, Sweden created an environment where smokers could easily transition away from cigarettes.
The power of this approach is most dramatically demonstrated by its effect on European migrants to Sweden, who show a smoking rate of just 7.8 percent after moving there. In comparison, their counterparts in their home countries maintain an average smoking rate of 24 percent. This striking three-fold difference proves that Swedish policies work regardless of cultural background or previous habits.
Spain, meanwhile, seems determined to follow the opposite path, joining the unfortunate company of countries like Venezuela and Turkmenistan — hardly models of public health innovation. Venezuela’s prohibitionist approach to vaping and heated tobacco products has left it with a stubborn 17 percent smoking rate, while Turkmenistan’s total ban on alternatives to smoking exemplifies the authoritarian, evidence-free approach that Spain now appears to emulate.
The Ice Harvesters of the 21st Century
The Spanish government’s regression on harm reduction brings to mind a historical parallel: the violent resistance to mechanical refrigeration in the 19th century. When refrigeration technology threatened to revolutionize food preservation, ice harvesters — whose entire livelihood depended on the status quo — responded with protests, vandalism of refrigeration plants, and attacks on early adopters.
Pedro Sánchez and his Ministry of Health are becoming the modern-day ice harvesters of nicotine innovation. Like their historical counterparts, they’re desperately clinging to outdated approaches while attacking the very innovations that could save countless lives. And like the ice harvesters, they’re doomed to end up on the wrong side of history.
Global Success Stories Spain Ignores
While Spain pivots backward, success stories continue to accumulate around the globe. Czechia has driven a remarkable 7 percent reduction in smoking in just three years through pragmatic policies: keeping vapes affordable through tax policy and allowing their use in spaces where cigarettes are banned. Greece, historically known for high smoking rates, has made a bold move by allowing manufacturers to communicate reduced-risk messages about their products, resulting in a 6 percent drop in smoking rates.
Beyond Europe, New Zealand has taken a pragmatic stance by explicitly recognizing vaping as a harm-reduction tool in its journey toward being smoke-free by 2025. Japan tells an equally impressive but different story, with heated tobacco products driving a remarkable 52 percent reduction in cigarette sales — through consumer choice alone, without any government promotion.
These examples demonstrate that innovation-friendly policies can achieve rapid reductions in smoking rates. Spain, however, seems intent on learning nothing from this wealth of evidence.
The Triple-A Approach Spain Needs
Sweden’s success stems from what we call at We Are Innovation the “Triple-A” approach to innovative nicotine products:
- Accessibility: Making diverse products available through multiple sales channels, including online platforms, with clear information empowering consumer choice.
- Acceptability: Ensuring product diversity through various flavors and nicotine levels, creating an environment where smokers can find options that genuinely appeal to them.
- Affordability: Keeping safer alternatives economically competitive with cigarettes, removing financial obstacles that might prevent smokers from switching.
Spain’s proposed regulations directly attack all three of these critical elements. Banning flavors decimates acceptability, crippling the potential for these products to attract smokers away from combustible cigarettes. The artificial nicotine limit on pouches assaults accessibility by removing viable products from the market. And these restrictions will inevitably impact affordability as compliance costs rise and product options dwindle.
The Human Cost of Political Posturing
The most tragic aspect of Spain’s regulatory regression is the human cost. Each percentage point of smoking prevalence represents real people whose lives could be improved or extended through access to less harmful alternatives. Sweden’s approach has delivered 21.2 percent fewer smoking-related deaths, 31.3 percent fewer cancer deaths, and 36 percent fewer lung cancer deaths compared to EU averages.
By turning its back on harm reduction innovation, the Sánchez government is choosing political posturing over public health. Like the ice harvesters who feared refrigeration would destroy food quality, today’s prohibitionists spread unfounded fears about innovative nicotine products while protecting the deadly status quo.
History teaches us that truly beneficial technologies eventually prevail despite resistance from those with vested interests in the status quo. However, that transition often comes at a human cost that could have been avoided with more open minds and evidence-based approaches.
Spain still has time to change course, to learn from Sweden and other success stories rather than following the failed prohibitionist paths of Venezuela and Turkmenistan. The question is whether Pedro Sánchez will recognize the lessons of history or continue playing the role of the modern-day ice harvester, futilely attempting to hold back the tide of life-saving innovation.
* Federico N. Fernández is a visionary leader dedicated to driving innovation and change. As the CEO of We Are Innovation, a global network of 45+ think tanks and NGOs, Federico champions innovative solutions worldwide. His expertise and passion for innovation have earned him recognition from prestigious publications such as The Economist, El País, Folha de São Paulo, and Newsweek. Federico has also delivered inspiring speeches and lectures across three continents, authored numerous scholarly articles, and co-edited several books on economics.
Source: We Are Innovation
