A puff, often seen as an innocent gesture, conceals a deep addiction. In Gipuzkoa, 19.2% of the population continues to smoke, according to INE data. Even a cancer diagnosis does not always guarantee an immediate cessation of tobacco use. To address this reality, the Cancer Association has launched a group therapy program in the Riberas de Loiola neighborhood, specifically designed for oncology patients.

This program, which has been running for years with a success rate close to 60%, has now shifted its focus, placing greater emphasis on oncology patients. Maider Sierra, prevention psychologist at Contra el Cáncer in Gipuzkoa, explains that "although it may seem otherwise, not all people stop smoking after a diagnosis." Some do so due to the initial impact but relapse, while others have never felt capable.

The therapy is conducted in small groups of about eight people and follows a clear structure that combines preparation, intervention, and long-term follow-up. The initial eight sessions are held weekly, followed by follow-up sessions at three, six, and twelve months. In total, eleven sessions are distributed over twelve months, responding to the complex nature of addiction.

However, the program does not always easily reach people. Currently, the workshop is not running due to a lack of participants. Maider Sierra acknowledges that "it is difficult for us to reach people." The reasons are diverse: lack of awareness of the service or emotional barriers. The psychological burden of cancer also plays a role, as some feel guilt or believe they have enough to deal with the oncological process without facing another challenge.

The problem of tobacco is no longer limited to traditional cigarettes. The association warns about the worrying rise of vapes and other nicotine products, especially among young people. "We are increasingly working on this issue in schools, high schools, and universities," explains Maider. They are observing that students in fourth or fifth grade are already consuming vapes, which has created an informal market among minors, where "puffs are being sold."

The misconception that vaping is less harmful than smoking is widespread, but Sierra emphasizes that "it is not better at all." Although in Euskadi these devices are equated with traditional tobacco, this is not always the case in other territories, leading to confusion and facilitating their use in spaces where they should be prohibited. For the association, prevention involves informing, especially younger generations, and dismantling the idea that there are harmless alternatives.

Group therapy offers support and identification in a context where smoking has become increasingly solitary. "A very beautiful atmosphere is generated. They understand each other, share, and learn together." Furthermore, quitting smoking has a direct impact on oncological treatment, improving the response to chemotherapy, radiotherapy, and immunotherapy, facilitating oxygenation and cellular recovery, and reducing the risk of relapse or developing a second cancer. Emotionally, it also helps manage anxiety and emotions.

Those who succeed in quitting experience a profound strengthening of self-esteem. "These are people who have tried many times, who come in a very vulnerable situation. When they succeed, the turn they give to their lives is impressive," states Maider Sierra. These individuals also often encourage others, with their stories serving as a mirror and impetus. Before joining the group, each patient undergoes a preliminary interview to assess if it is the right time and if this approach is what they need, as quitting smoking is a process that requires time, support, and accompaniment.