The 54-year-old man, from Galicia, saw himself on the back of a pack of Marlboro Lights with the caption: “Smoking can cause embolisms and disability.”
The photo was taken when he was unconscious and attached to breathing apparatus while undergoing surgery at the Santiago de Compostela hospital last year.
He said that many of his neighbours had recognised him on the packets.
““I am in that hospital bed not because of the consequences of smoking but because of back problems,” he said, explaining that he had a titanium plate fitted in his spine.
Health authorities have launched an investigation.