Dr. Matthew Sadlier:

I thank the Chairman and members of the committee for the opportunity to address them on the issue. Ireland has been a global leader in the fight against tobacco since implementing a ban on smoking in the workplace in 2004. As such, it is crucial that Ireland continues to lead the way by legislating for cigarette packaging that is plain and contains appropriate health warnings.
Tobacco is unlike any other product on the market. It is the only legal consumer product that kills when used as intended by the manufacturer. Half of all smokers will die from a tobacco-related disease and not only are 90% of lung cancers caused by tobacco but it is also a contributory factor in 30% of all cancers. A quarter of deaths from coronary heart disease and 11% of all stroke deaths are attributable to smoking, and smokers are two to three times more likely to suffer a heart attack compared to non-smokers. It is also a risk factor for asthma in children. Tobacco is one of the leading preventable risk factors for non-communicable diseases such as cardiovascular disease, cancer, lung disease and diabetes.
The overall prevalence of smoking is declining but in 2012, some 22% of the population still smoked. Smoking is an addiction that begins in adolescence and according to a survey commissioned by the office of tobacco control, 78% of smokers started smoking before they reached the age of 18, and 53% started before they reached the age of 15. In 2010, some 7.9% of children aged ten to 17 reported smoking cigarettes every week. However, the percentage of children in that age group who report never smoking has increased from 50.8% in 1998 to 73.5% in 2010.
This new Bill provides the opportunity to capitalise on these developments further by reducing the attractiveness and appeal of tobacco products to children. The Irish Medical Organisation has long championed efforts to reduce the number of smokers in Ireland, and at our last annual general meeting we passed a motion supporting the Minister for Health’s planned introduction of standardised packaging for tobacco products. As such, the IMO welcomes the tobacco-free Ireland policy and the proposed Bill.
However, the Public Health (Standardised Packaging of Tobacco) Bill only calls for 65% of the package to be covered with a health warning, which is the minimum required by the forthcoming EU tobacco products directive. The IMO believes this does not go far enough and advocates for 75% coverage by health warnings in order to protect the well-being of Irish citizens. There is a growing body of evidence on the effectiveness of graphic warnings. For example, a Canadian research paper, which surveyed individuals over a ten-year period, found that graphic warnings had a statistically significant effect on smoking prevalence and quit attempts. In particular, the warnings decreased the odds of being a smoker and increased the odds of somebody making an attempt to quit being a smoker. Cancer Research UK reports that all quantitative studies found standard packs less attractive than branded equivalents to both adults and children. Furthermore, a major piece of research by Cancer Research UK and the University of Stirling indicates:

...branded packaging presented positive user imagery and functional and emotional benefits to young people. Conversely, plain cigarette packaging was perceived as unattractive, reduced emotional attachment to the packaging and enforced negative smoking attitudes among young people.

Evidence is already available that plain packaging works. In Australia, the introduction of plain packaging for cigarettes spurred a 78% increase in calls to the quitting helpline, according to a new study by the Cancer Institute of New South Wales. Smokers are more likely to consider giving up and they are also more likely to think the quality of their cigarettes has diminished with plain packaging. Research also shows that when young people look at plain cigarette packs, they believe the product is used by people who are less stylish and sociable, and not as attractive to mimic as alternative packaging.
An often cited point by big tobacco companies is that plain packaging will increase illicit trade but a report conducted by Cancer Research UK in 2012 on smuggling and the tobacco industry found that there was no evidence that plain packs increase smuggling or illegal trade in cigarettes. On the smuggling issue, the IMO congratulates the Government on signing the protocol to eliminate illicit trade in tobacco products, and this treaty will, we hope, help mitigate the illicit trade of tobacco products globally. These companies try to influence policy for the sole purpose of increasing their profits to the detriment of public health. The IMO is also calling on the Government to place a "polluter pays" type of levy on tobacco manufacturers so they can make a contribution to the health care costs of tobacco use.
The IMO believes that Ireland needs to continue to be a front runner in the fight against tobacco. As such, introducing plain packaging with appropriately sized graphic health warnings would be a crucial investment in the long-term health of the country.