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This paper describes the causes that generate the relatively high – among comparable OECD countries – prevalence of tobacco consumption in Spain. It evaluates the current policy interventions geared towards reducing incidence and prevalence. It argues that, despite a recent major breakthrough in legislation on advertising and consumption in public places, one of the major shortcomings of current policies is the lack of an effective fiscal policy. This lack of effectiveness is explained by some idiosyncrasies of the Spanish cigarette market that call for specific measures. [ABSTRACT FROM AUTHOR]