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“Hold your breath,” my mom would say.
Growing up in the Seattle suburbs, it was not difficult for my parents to shelter their sons from cigarette smoke. The neighborhood was spaced out, and lots of trees and other greenery meant better air quality.
In the downtown district, they would be more on their guard. If they noticed someone smoking, they alerted us. We made it a game, taking a deep inhale and puffing out our cheeks like chipmunks.
Smoking bans in the United States began in 1995, and Washington state passed its major smoking initiative in 2005. Spain started prohibiting smoking in its hospitals and schools a year later, but at the time still permitted smoking inside restaurants and bars.
There was plenty of skepticism in 2011 when Spain expanded its ban to include the hospitality sector and most other public places. “It would close down many small businesses.” “The government would not be able to enforce the rules.” “The new law would be inconsistent and ineffective.”
Six years later though, the law has held firm.
Most Spaniards agree it is not as visible today, however I was still taken aback when walking in León and seeing how many people were smoking right outside buildings. Smoking even was common in outdoor seating areas in restaurants (which is legal, the law only prohibits smoking inside).
In a 2013 report from the Tobacco Atlas, published by the World Health Organization (WHO), Spain checks in as having a higher percentage of daily tobacco users than other nations qualified as ‘high-income,’ including the United States.
Granted, these statistics were taken just two years after the stricter legislation was passed, but some believe more can be done through actions does not require more laws.
Educating and informing
“My son, nobody talks to him about smoking,” said Santos Rodriguez. “So it falls on us, his parents, to say that this is absolutely wrong and absolutely unhealthy. But at school, he doesn’t get any advice.”
Rodriguez teaches English for adults at the University of León’s language center. His students add that at schools, there would be occasional seminars about a variety of topics including smoking, but attendance was voluntary.
Semesters of health were required in both middle school and high school to graduate in Washington. The hazards of regular smoking were discussed along with the consequences of alcohol, drug addictions and unprotected sex. In addition, the benefits of things such as a balanced diet and regular exercise were included in the syllabus.
While it is still up to the individual student to determine how much they learn from those classes, simply identifying smoking as a cause for poor health later in their lives, is an important first step.
The primary purpose of bans on public smoking is to prevent people from being harmed through secondhand smoke, a health risk first identified in 1986. The other perhaps surprising benefit is that it reduced the normalcy of smoking.
From an era when there were no laws, Barros Garcia describes how she began smoking.
A University of Washington study published in 2005 showed children of parents who smoked were more likely to begin smoking as a teenager. Barros Garcia said having a husband and friends who did not smoke at all was a reason why her three children never thought about trying.
More measures have been taken to change how smoking is seen. The Fédération Internationale de Football Association (FIFA) partnered with WHO and now tobacco companies cannot sponsor professional soccer teams.
Cigarette packages now carry health warnings and vivid images of damaged lungs and people suffering from diseases correlated to habitual smoking.
Although smoking as an unhealthy and life-threatening habit is not as talked about as much as it should be in school, other measures are at the very least minimizing its promotion.
Sticking to the recovery process
Five appointments spread over three months. Phone check-ins over the following nine months. A combination of medications and therapy. If everything goes to plan, the patient should be able to drop their smoking habit within a year.
Jesús González is a specialist in addictions, receiving referrals from general practitioners and other specialists in other fields.
Unfortunately, some don’t even think about seeking a doctor’s advice, or believe they can quit on their own.
Barros Garcia has been trying to quit smoking for a number of years now, despite not having any current correlated medical conditions. She sees a general practitioner, but only when she feels a little sick. That only amounts to 2–3 times a year at most, and she does not see the need to visit more often or see a specialist.
The struggles patients face trying to quit on their own is not new for Jesús González. She noted that even patients in her treatment plan would rarely be able to fully quit the first time.
People think Spain’s ban on smoking succeeded because fines were not only given to people who smoked, but were also handed out to any business owner or store manager in charge of the place. It also put an extra burden on workers, because they would have to sign out to go outside to smoke, which led to putting in extra time at the end of the day.
But making it more inconvenient to find time to smoke was in many cases not enough to get people to seek medical advice.
Jesús González said that by collaborating with other physicians, they are able to present a patient’s medical history and convince them to try to quit smoking.
Waiting to ask for help until diagnosed with a life-threatening illness is not wise, but is what some end up resorting to.
Who has their annual World No Tobacco Day on May 31, a day that Jesús González said people mobilize in an effort to distribute information and help people understand why it is important for them or their friends and family members to quit.
Fortunately though, these efforts and evaluations are not just taking place in Spain on one day, but throughout the year.