Friday, July 2, 1999
May I ask you to introduce yourself ?
My name is Manel Nebot, I had a training in family and community medicine after studying Medicine in Barcelona, even though I never practiced: I "shifted" to public health in 1985 as a research fellow and became part of the Health Promotion Unit developed at the Barcelona City Health Department in 1986, during these days of "Ottawa spirit".
I got the position of Head of the Unit in 1993, after one year of post-doctoral fellowship in Johns Hopkins. Running prevention and health promotion programmes lead us to get more and more involved in smoking prevention and control activities, although our scope includes other more "traditional" preventive activities, as the immunization program.
1. Could you tell us about the tobacco control programs at the city level in Barcelona?
Basically, we are running smoking control activities in three domains: public information (i.e., developping and coordinating smoking cessation programs in health care settings or population-based campaigns as the Quit and Win contest); monitoring and enforcing smoking policy in public places (i.e., observational studies in Universities, underground, campaigns to raise awareness and commitment to current laws at the school level); and developping and implementing innovative educational interventions at the school level (i.e., the ESFA project, the Smoke-free Class or the development of a multimedia tool for smoking prevention at the school level).
2. Are there other "city-based" tobacco control programs in Spain? If so, are they similar to yours and do you keep in touch with each other?
Most tobacco control initiatives in Spain are regulated at the national or regional level. The situation of the Barcelona City Health Department is quite unique for historical reasons. However, as you know well, regarding smoking control it is "healthy" to give ground to more local, specific activities, although they are obviously more efficient when they happen in a coherent, supportive context.
3. Barcelona is in Catalonia, a region with a strong identity and sense of independance. Is tobacco control part of the regional policies in Catalonia?
Catalonia pioneered tobaco control in Spain in the 80s. Now, many other parts of Spain have started control programs. We need to respond to the new initiatives by the industry, which challenge the regulations, and to improve implemention of some regulations.
4. Iberia still allows smoking on its international flights.Is that a symbol of the situation now in Spain where it seems smoking is still the norm and tobacco control remains marginal? How do you assess the tobacco control policy at the national level now?
Iberia is not likely to adopt self regulations. Tabacalera owns a fair share of Iberia. In fall 1999, all domestic flights in Spain will become smoke free. Now we need regulation of European Union flights, of all international flights. Air line workers could play a crucial role, but so far have not been active on this topic.
5. I believe a lawsuit was filed against Tabacalera by a tobacco victim.
Could you tell us about this case, is it still pending? Do you
foresee new developments in litigation, like the "collective action"
filed in France by a local health insurance unit?
This case is still pending. The most interesting news is the case recently won in courts againt Tabacalera by a Consumer Organization (the Asociacion de Usuarios de la Comunicacion), as Tabacalera was running indirect ads on TV.
Do you have anything else you would like to add?
Yes, I think that the situation is not to be optimistic: a large proportion of adult men are regular smokers while the proportion of smokers among women seems to increase rapidly and the incidence of new smokers among youth remains stable -at best-. It seems that we are all underestimating the problem: many people, and very acutely these days youth and women may still see a symbolic power in smoking that pays off the "supposed" health risks; on the other hand, the difference between the efforts made by the industry and the public sector is just enormous. We do need a real shift (more investment, perhaps more taxes) if we want to change the trend in the next future.
Thank you Manel for taking the time to be with us today.
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