¿Por qué nosotros no? Acción Ciudadana por la Salud y el cambio de la Ley Española de Tabaco

... extend to all parts of a prison, including exercise yards.

Senior prison staff were said to have been informed of the move in a letter.

"You will no doubt be aware that the decision has been made that the time is right for the prison estate to adopt a tobacco and smoke-free policy to provide a smoke-free workplace/environment for our staff and prisoners," the letter, quoted in the Times, said.

The Prison Officers Association (POA) began campaigning for a smoking ban in all UK prisons in 2007.

It had expressed concerns about staff and prisoners "forced to suffer the harmful effects of second-hand smoke".

It came after smoking bans were introduced across the UK, to protect people from the effects of second-hand smoke in workplaces and enclosed public places.

The bans did not apply to prisoners as their cells were defined as "domestic premises", although non-smoking prisoners could not be made to share a cell with a smoker.

Guernsey Prison governor Dave Matthews told the BBC a smoking ban enforced earlier this year at Les Nicolles jail had "gone very well".

"We have removed tobacco but also provided prisoners with some assistance to try and give up their nicotine habit through the form of patches and the use of Quitline."

"For those who have decided not to (quit smoking)," he continued, "we have allowed them to purchase their own e-cigarettes, which deliver nicotine in a much safer way than normal tobacco does".

Guernsey and the Isle of Man were the first two European jurisdictions to introduce a blanket smoking ban in prison grounds.

Mr Matthews told the BBC there was a lot of negative response at first, "but that was understandable as people don't want to give it up".

'Pressure on jails'

POA general secretary Steve Gillan told the Times the union would work with the Ministry of Justice to make sure a ban "works effectively".

He acknowledged it "could cause disturbances" but pointed out a ban had successfully been introduced in young offender institutions in England and Wales.

Andrew Neilson, from campaign charity the Howard League for Penal Reform, suggested a ban would be difficult to enforce.

He told the BBC: "Prisons are going through unprecedented budget cuts, prison resources, staff resources have been cut. There may well be good intentions behind this policy proposal, but it will undoubtedly put a lot of pressure on jails which are already pretty stretched."

He added there could be a damaging effect in the short term on the mental health of prisoners "who are often very distressed".

Former offender Mark Johnson, chief executive of the charity User Voice, said there are "greater priorities" that need addressing in the prison system, such as rehabilitation.

He criticised the Ministry of Justice for "tinkering around" with the issue of smoking, which he believes is a human right.

He told BBC Radio 4's Today programme: "We've got a serious problem the way we have the rates of reoffending, and they sort of come up with... a PR line about something as minute as smoking in cells.

"We work in a number of prisons around the country and already in communal spaces smoking's banned. The only place that you can smoke is actually in your cell."

A ban on smoking in workplaces and enclosed public spaces came into effect in England in July 2007 following similar legislation in Scotland, Wales and Northern Ireland.

... for amendment of laws”.

Public health doctor Joseba Zabala Galán, coordinator of the grassroots movement Don’t Touch the Law, and member of the board of the Spanish National Committee of Tobacco Prevention said: “Allowing the 17 autonomous communities the ability to establish differences in the smoke-free laws, besides being a legal by-pass, would mean the end of the current Spanish smoke-free model. It would be a terrible precedent that would weaken the current successful strength and collective belief of the smoke-free law as a real and effective health public tool. We urge all concerned citizens and organisations to support our campaign to keep the current law.”

... regulate them, though analysts expect that the agency will start soon.

Thomas Briant, executive director of the National Association of Tobacco Outlets, which represents 28,000 stores, said the study “raises too many unanswered questions,” for the data to be used for policy making. It was unclear, for example, whether students who tried e-cigarettes were using them regularly or only once. He pointed out that selling them to minors is now illegal in many states.

One of the biggest concerns among health officials is the potential for e-cigarettes to become a path to smoking among young people who otherwise would not have experimented. The survey found that most students who had tried e-cigarettes had also smoked traditional cigarettes.

But one in five middle school students who said they had tried e-cigarettes reported never having smoked a conventional cigarette, raising fears that e-cigarettes, at least for some, could become a gateway. Among high school students, 7 percent who had tried an e-cigarette said they had never smoked a traditional cigarette.

Dr. Frieden said that the adolescent brain is more susceptible to nicotine, and that the trend of rising use could hook young people who might then move into more harmful products like conventional cigarettes.

Murray S. Kessler, the chairman, president and chief executive of Lorillard, a North Carolina-based tobacco company that owns Blu eCigs, said that the rise in youth usage was “unacceptable,” and added that the company was “looking forward to a regulatory framework that restricts youth access” but does not “stifle what may be the most significant harm reduction opportunity that has ever been made available to smokers.”

The sharp rise among students mirrored that among adult users and researchers said that it appeared to be driven, at least in part, by aggressive national marketing campaigns, some of which feature famous actors. (Producers say the ads are not aimed at adolescents.) E-cigarettes also come in flavors, which were banned in traditional cigarettes in 2009 and which health officials say appeal to young people.

“Kids love gadgets and the marketing for these things is in your face,” said Gary A. Giovino, a professor of health behavior at the University at Buffalo. He added that the rising use of e-cigarettes risked reversing societal trends in which smoking had fallen out of fashion.

About 6 percent of all adults — not just smokers — reported having tried e-cigarettes in 2011, according to a C.D.C. survey, about double the number from 2010. Data for adults in 2012 are not yet available, a spokesman said.

... smokers in the population fell from 26% in 2006 to 24% in 2012, the lowest in 25 years. The incidence of heart attacks has fallen by 11% since the 2006 legislation was established.3 Moreover, the European Commission has stated that Spain experienced a 70% fall from 2009 to 2012 in the proportion of people exposed to second hand smoking, the biggest fall among EU member states in that period. The average fall in the EU was 46%.4

Campaigners fear that Adelson will get his way because of the predicted economic benefits of the casino. He is claiming that

the casino will bring 200 000 jobs to the area and prosperity to the region.

Though the central government has stated that “at present” there are no plans to amend the law, the president of the autonomous community of Madrid, Ignacio González, from the conservative People’s Party, has called for an exception to be made.

Health professionals are fighting the proposals. An umbrella body of different tobacco control organisations in Spain (www. porquenosotrosno.org) has launched the campaign “Don’t touch the law” (http://bit.ly/1e8Hlup) to get international support to prevent the change.

Francisco Rodríguez, president of the Spanish National Committee for Smoking Prevention, told the BMJ, “With these laws [banning smoking in public places] tobacco consumption has been denormalised. Allowing smoking in the casinos would be a tremendous step backwards that could have a contagious effect on other sectors.”

1 García Rada A. Spain votes to ban smoking in public places. BMJ 2010;341:c7429. 2 García Rada A. Fighting big tobacco in Spain. BMJ 2010;341:c6462.

3 Agüero F, Dégano IR, Subirana I, Grau M, Zamora A, Sala J, et al. Impact of a partial

smoke-free legislation on myocardial infarction incidence, mortality and case-fatality in a population-based registry: The REGICOR Study. PLoS One 2013;8:e53722, doi:10.1371/ journal.pone.0053722.

4 European Commission. Report on the implementation of the council recommendation of 30 November 2009 on smoke-free environments (2009/C 296/02). http://ec.europa.eu/ health/tobacco/docs/smoke-free_implementation_report_en.pdf.

Cite this as: BMJ 2013;347:f5598 © BMJ Publishing Group Ltd 2013