Mr. Chris Fitzgerald:

I will begin with some general comments and then answer the specific questions. Ms O'Brien will pick up on some of the questions. To respond to the point raised by Deputies Ó Caoláin and Kelleher it is important to emphasise that we are discussing a directive developed by the EU Commission. We see it as part of what we are trying to do in terms of tackling the problems with tobacco. It is now open to the 27 member states to develop and adapt this Commission initiative.

We are involved in the process because it is on the table and Ireland has the Presidency. It is a priority that we steer the issue. We are broadly supportive of the directive, as it is consistent with what we want to do.

Deputies Ó Caoláin, Kelleher and Byrne asked a general question on what we know about the reasons people start smoking and what the proven interventions that states can make are. We are constantly researching. As Senator Burke mentioned, we can never have too much research in this regard. In consultation with our colleagues in Northern Ireland, we have commissioned research on the reasons young people start smoking. Research informs policy.

The kinds of measures that are proven and are broadly accepted internationally as being effective are pricing, legislative control, information and education, and offering cessation services. These four are the tried and tested remedies. We have consistently tried to keep the cost of tobacco high. One of the complaints we constantly receive is that the cost of tobacco in Ireland is high. We recognise the fact that cost is a factor. The banning of packets of fewer than 20 cigarettes feeds into this thinking.

We have been at the forefront in terms of legislation. A legislative framework allows one to take certain actions. Legislation is important.

Information and education are very important. Through the years, we have invested heavily in public awareness media campaigns. To address Deputy Ó Caoláin's point, there is a cross-sectoral dimension, in that we must work in partnership with the Department of Education and Skills, community groups and whatever groups are working in this field. This initiative cannot be driven entirely by our Department or from within a legislative framework. Promoting school initiatives and so on are important. The HSE has been involved in many initiatives, working with communities around a range of health promotion issues, of which smoking is one. We must continue to be innovative in terms of how we reach out to young people in schools and communities and to adults in workplaces and so on. There is a role for other actors.

Deputy Kelleher or Deputy Naughten asked about the percentage of cost. The figures I cited were from the most recent EU study on this matter, which examined annual EU health care expenditure. The spending is largely hospital based and amounts to €25.3 billion, minus productivity losses. It equates to approximately 3% of health spending. However, if one considers the larger picture - the lost years of life and so on - the percentage increases considerably.