A few weeks ago, the results of the latest survey on alcohol and other drugs in Spain (EDADES 2024 Survey) appeared. This is a survey directed by the Government Delegation for the National Plan on Drugs (DGPNSD), which is carried out every two years. It was established in 1995. This survey provides relevant information on the characteristics and prevalence of tobacco and electronic cigarette consumption, widely used by all Spanish healthcare professionals.1 The analysis of the results of the last survey offers more data for concern than for satisfaction.
It has been highlighted that one of the most welcome results of this survey has been the significant decrease in the prevalence of tobacco consumption in all its measurements: at some point in life, in the last 12 months, in the last month, and daily. For example, the prevalence of daily tobacco consumption has been reduced from 33% in 2022 to 25.8% in 2024. This is the first time that a reduction has been observed since the beginning of the historical series.1 Without a doubt, this is relevant information. But it is worth evaluating it properly before claiming victory. It must be taken into account that the EDADES survey, when analysing tobacco consumption, refers to the consumption of conventional cigarettes, rolling tobacco, or both.1 However, it does not reflect the consumption of a very new form of tobacco that appeared a few years ago and that in the last two years has multiplied in our country: the use of heated tobacco. We know that, in 2023, the sale of heated tobacco in Spain increased by 17% and that it did so mainly in those over 30 years of age.2 It should be considered that the reduction in tobacco consumption detected in the 2024 EDADES survey may perhaps be hiding this noticeable increase in the consumption of heated tobacco, as the sales figures for this type of tobacco indicate.2 Besides this fact, it is enough to point out that the greatest drop in the prevalence of tobacco consumption has occurred in those over 30 years of age.1 It would be advisable for future surveys to include some questions to determine the consumption of heated tobacco, especially when it is known that the consumption of this form of tobacco is as harmful as that of conventional cigarettes.3 Another data not included in the survey concerns dual smokers. It would be important to determine this data in future surveys. It is essential to emphasize that many of those who begin using e-cigarettes to quit smoking eventually become dual smokers. Even some of those who only use e-cigarettes use them as a gateway to smoking conventional cigarettes. It is worth noting that another reason for this reduction in the prevalence of tobacco use could be the implementation of funding for various drugs to help people quit smoking, which has led a significant number of smokers to attempt to quit smoking.
Another not very encouraging data point from this survey is the shocking increase in the prevalence of electronic cigarette consumption in all its measurements: at some point in life, in the last 12 months, in the last month, and daily. For example, the prevalence of lifetime electronic cigarette consumption increased from 10.5% in 2020 to 12.1% in 2022, but in 2024 it has turned out to be 19%, that is, in just two years, prevalence has increased 7 points.1 Furthermore, in this section another relevant observation has been made: the number of those who use electronic cigarettes to quit smoking has decreased (37.4% in the 2024 survey compared to 44.9% in that of 2022), and even the number of those who use them with nicotine (54% in the 2024 survey compared to 75% in the 2022 survey). All this data could suggest that the number of those who use electronic cigarettes for recreational purposes is increasing continuously. It is important to note that using electronic cigarettes even without nicotine is harmful to health.1,3
In this 2024 survey there are other positive data that shed light on a better future: data on the percentage of people who have considered quitting smoking and the percentage of people who have tried to quit smoking. In the 2022 survey, the percentage of those who considered quitting smoking was 64.2%, and in the 2024 survey it is 67.7%; and regarding the percentage of people who tried to quit smoking, in 2022 it was 41.9%, and in 2024 it was 44.1%.1 This data shows that the number of smokers who want and try to quit smoking progressively increases.
Taking into account what has been discussed here, we would like to make the following suggestions:
- 1.
Reduction in the prevalence figures for tobacco consumption found in the last EDADES survey could be hiding a significant increase in the prevalence of heated tobacco consumption. For this reason, it is suggested that the next EDADES survey introduce some questions to rule out or confirm this fact.
- 2.
The disproportionate increase in the consumption of electronic cigarettes in all its measurements and the increase in their use for recreational purposes suggest that the use of these devices is becoming normalised in our country, and this will be very detrimental to the total control of smoking. This will be detrimental to the fulfilment of Tobacco Endgame objectives.4
- 3.
Data indicating a greater number of smokers who want to quit smoking and who are making attempts to do so speaks to the need to increase public healthcare for all smokers to help them quit by creating and strengthening smoking cessation services in primary and hospital care settings and by publicly funding all smoking cessation medications.5
Finally, and as a summary, we want to highlight the need to update national legislation on the regulation of tobacco consumption, sale, and advertising. All new forms of tobacco use (electronic cigarettes, heated tobacco, water pipes, and nicotine pouches) must be controlled for legal regulations.3,6 Furthermore, all smokers must have access to adequate public healthcare to help them quit smoking.5
FundingNothing to declare.
Authors’ contributionsMC-F produced the first and main version of the manuscript. Then the manuscript was revised by CAJ-R and JIG-O. After that MC-F produced the final version of the paper.
Conflict of interestAuthors declare no conflict of interest.
