Mr. Damien Peelo:

Good morning Chairman and members of the committee. I thank the committee for inviting us here today. COPD Support Ireland is a national network of local groups led by people living with COPD. Our focus is to raise awareness of COPD and the profound link between smoking and the development of this disease. COPD is probably not as well known as other illnesses but it is estimated that 440,000 people are living with the disease in Ireland today. Smoking is the lead cause of COPD. There are approximately 1,500 deaths per year from this disease and over 90% of all sufferers are smoking or are ex-smokers. COPD is the collective name for lung conditions that make it hard for sufferers to breathe due to obstruction in the air passages of their lungs.

It is a progressive, disabling disease with a significant extra-pulmonory effect and it has a major impact on the lives of patients, families and carers, in addition to the health care system. COPD cannot be cured. Even when a person quits smoking, the damage to the lungs is not reversible. The consequences of smoking are lifelong. One sufferer has said the condition is such that it is like trying to take a breath with an elephant sitting on one's chest.

There are approximately 11,000 admissions to hospitals each year of COPD patients, representing approximately 120,000 bed days utilised. There are huge costs associated with that. An uncomplicated admission of a COPD patient costs over €4,000, and a complicated admission can cost €7,700. The average length of stay is nine days. Therefore, one can see how the costs build up.

Although smoking is the leading cause of COPD, 77% of Irish people do not know this. This indicates that the health warnings are currently not effective enough in deterring people from taking up smoking. More needs to be done. Smoking is a factor in 90% of cases of COPD. Most of those affected have smoked over 20 cigarettes per day for up to 20 years. Up to 50% of lifelong smokers will develop COPD. An individual who is highly exposed to passive smoking is 48% more likely to present with COPD than an unexposed individual. Given the adverse effects of cigarettes in terms of COPD, the disease can have a lag period of up to 15 to 20 years. These rates have significant health implications for the medium and longer term.

We have heard a little about passive smoking already. What was said applies to those with COPD. While the workplace ban has limited the number of places in which people can smoke, passive smoking has a huge impact on people with COPD. Our members tell us that smoking poses a problem daily as people must walk past smokers on the street or gathered outside public buildings, such as hospitals, pubs or cafés. Even being in a vehicle where smoking has recently occurred can induce a coughing fit and immobilise a person with COPD. It is very important to reduce the number taking up smoking rather than just restrict the number of places where people can smoke.

COPD is adversely associated with socioeconomic status. The effects are reflected in the risk factors for the disease. The smoking rate in Ireland among those in the most deprived social groups is high compared with the national rate. Among homeless men in Dublin, the smoking rate is 78%. These social and economic gradients are reflected not only in the prevalence of smoking but also in the prevalence of COPD and the outcome for those with COPD in terms of morbidity and mortality.

COPD Support Ireland fully supports the Bill to standardise the packaging of tobacco. Smoking is a dominant cause of COPD. Discouraging young people from taking up smoking is a key preventive measure in tackling the disease. On seeing a mock-up version of a potential plainly packaged box of cigarettes, a 50-year-old woman commented: "I wish I had never started smoking. I would not have taken up smoking if those images were on the packs. You would be mortified to take that out". The statement was made by Paula, who smoked ten cigarettes per day from the age of 16. She is present today in the Visitors Gallery because she is determined to prevent and passionate about preventing others from taking up smoking. She believes plain packaging will have an impact.

COPD has a considerable impact on the quality of life of all patients. It involves long-term medical care and, for many, frequent hospital admissions for the treatment of exasperations, which often result in premature death. As with many chronic conditions, COPD not only affects the patient but also has a significant impact on the family, carers, health services and wider society. Given that 90% of cases are caused by smoking, it is imperative that we act now to minimise the potential of future generations from taking up the addictive habit. The Bill represents an important step towards protecting young people and future generations from addiction to tobacco products. The swift introduction of the legislation will ensure that the health of Irish citizens is prioritised over the efforts of the tobacco industry to weaken and delay a significant public health protection.