The Spanish region of Galicia on Thursday brought in a de facto ban on smoking in outdoor public spaces in a bid to reduce the transmission of Covid-19, a move set to be followed by several other regional governments.
Alberto Núñez Feijóo, the president of Galicia, said that smokers and vapers would now not be allowed to puff in the street or when seated at a terrace café unless they could be sure of keeping a distance of two metres.
Similar measures have been imposed in other parts of the world, most notably in South Africa, which banned tobacco sales in March and is now fighting a legal challenge from British American Tobacco. The links between smoking and coronavirus have been the focus of considerable attention, both in terms of transmission and severity.
Already battling to contain rising infection rates, Spain saw a dramatic leap in its daily number of infections on Thursday, reporting 2,935 up from 1,690 the previous day.
Mr Núñez Feijóo said the Galician decision had been based on scientific advice to the effect that smoking could help spread the respiratory illness.
“Several members of our clinical committee agreed that smoking without any restrictions without observing a safety distance, be it at an outdoor bar with people close by or in other crowded areas, constitutes a high risk of infection,” the Galician leader said.
Smokers caught flouting the ban will be expected to pay a 100-euro (£90) fine, the same penalty as is handed out for not wearing a face mask in a public place.
The Canary Islands said it would also enact a ban from Friday, while several other Spanish regions revealed that they were preparing to follow suit, including Andalusia, Castilla-La Mancha and Castilla y León. Officials from Madrid, Valencia, Navarre and Asturias said the possibility of a ban on smoking in public was also on the table.
Spain’s national health service recommended a ban on smoking in public last month, noting the need to adjust face masks and the possibility of smokers expelling Covid-infected droplets.
The recommendation paper also says that smokers are more likely to develop severe health problems as a result of contracting Covid-19.
“We know that smokers with Covid-19 have a greater viral load and are potentially bigger spreaders,” said Alberto Fernández Villar, head of the pneumology department at Vigo hospital, and a member of the Galician government’s clinical committee.
Talking to the newspaper El País, Dr Fernández Villar also said that the risk of Covid developing into a severe pneumonia was “five to eight times greater” among smokers.
Linda Bauld, professor of public health at the University of Edinburgh, said there was no published research showing that Sars-CoV-2, the virus that causes Covid-19, could be spread through smoke or vape.
But she added: "Given the evidence that the virus is airborne as well as transmitted through droplets it's not outwith the realms of possibility that you could come into contact with virus droplets if you walk through smoke or vape."
Several hospital-based studies have linked smoking to the more serious symptoms of coronavirus. In April, one French study conversely reported a lower prevalence of smoking among sufferers than in the general population, suggesting that nicotine might instead afford some protection from the disease, but the World Health Organisation questioned its reliability.
The WHO does however note that there are no authoritative studies on the link, saying that while smoking is "likely related to severity", more research is needed.
For some, the Galician ban on smoking within two metres of others remains insufficient. An online petition by a Spanish anti-smoking campaign group has gathered more than 80,000 signatures demanding a complete nationwide ban on all smoking at outdoor bars and restaurants.
“In this way we will be able to enjoy the thing we all love, which is to appreciate our gastronomy at outdoor bars free of smoke,” the petition organised by Nofumadores.org says.
According to 2019 figures, 22 per cent of Spaniards are daily smokers.