Dr. Helen McAvoy:

I thank the Chairman and committee members for the invitation to address the meeting today.The Institute of Public Health in Ireland is an all-island body established to achieve greater co-operation for public health on the island. Tackling health inequalities, a situation where the poorest people experience the poorest health and better off people experience better health, is a core theme in all of our work. Higher smoking prevalence and tobacco-related harm among the most disadvantaged in society means the Bill is of particular importance to us. The IPH was pleased to forward a written response in advance and our oral presentation will present key issues from the wider paper.
The IPH strongly supports the introduction of standardised packaging under the Public Health (Standardised Packaging of Tobacco) Bill 2013. We have carried out extensive work on tobacco and our latest publication, along with the Tobacco Free Research Institute, is entitled A Tobacco-Free Future – an all island report on tobacco, inequalities and childhood 2013 clearly laid out the data on tobacco and childhood, including the legacy of smoking and pregnancy.
The introduction of the Bill is necessary to support Ireland’s goal of being tobacco-free by 2025. It is an important stepping stone for our children on the road to a tobacco-free future. Smoking is a major public health issue with around 1 million people in Ireland smoking at present resulting in a cost of between 6% to 15% of the total health budget being spent on tobacco-related disease.
The institute's key message is that tobacco control works. A trend of lower uptake of smoking among young people in Ireland is consistent from 1998 to 2010.It is the direct result of a stepwise introduction of tobacco control measures that have succeeded in reducing the appeal and accessibility of smoking to young people. These measures have included the banning of advertising, removal of point of sale display and the introduction of smoke-free environments in workplaces and public spaces that "denormalises" smoking for all in society. International evidence shows that the more comprehensive the basket of tobacco control measures adopted the better the results. Therefore, standardised packaging is a logical progression for policy in Ireland.
Our next key message is that standardised packaging works. Systematic reviews, that covered 37 studies screened from 4,518 citations addressing the evidence on standardised packaging, concluded that there are strong grounds for believing that current packaging glamorises smoking and that tobacco products packaged in a standardised colour, typeface and form will improve the effectiveness and salience of health warnings, reduce the misconception of relative harmfulness of various brands, be they lights or natural, and will reduce the overall appeal of smoking.
This week a study, published in the Medical Journal of Australia, again reported a 78% increase in calls to a quitline that was associated with the introduction of standardised packs. The effect of this has been very sustained. We believe that reducing the appeal of tobacco to young people is essential and studies have found that plain packaging was considered a deterrent, particularly by younger respondents. It projects a less desirable smoker identity and further "denormalises" tobacco as a regular consumer product.
We view the development as an evidence-based, logical, cost-effective and necessary response to the tobacco epidemic in Ireland. The World Health Organization has estimated that 20% of all mortality among males and 16% of all mortality among females in Ireland is attributable to tobacco. The current burden of tobacco-related disease, disability and death on this island is unacceptable. There is no age group, social group and family in the State that has been untouched by the loss of a loved one or friend through tobacco-related disease.
Over the past decade Ireland has been successful in improving life expectancy. Many more people can now look forward to living into their 80s and beyond. However, the gift comes with a responsibility to ensure that those extra years are spent in good health and as free of disability as possible. Successful tobacco control is an imperative if the health system is to meet the challenge of rising chronic disease and disability into the future. Reducing smoking is necessary as a means to end human suffering firstly. It is also necessary to contribute directly to a better population health - a cornerstone of human capital and a driver of economic prosperity and growth.
To be really successful in the most cost-effective way possible, tobacco control must extend beyond the use of health education and smoking cessation approaches. It must include evidence-based approaches to reduce the appeal and accessibility of tobacco products to young people and to "denormalise" smoking in society.
The development of the Bill is in line with our current tobacco control policy and Ireland’s commitments as a signatory to the Framework Convention on Tobacco Control. The move towards standardised packaging of tobacco is now beginning to gain momentum across Europe and globally. In the UK in 2012 a consultation on standardised packaging showed consistent and strong support for standardised packaging by all parties with a declared interest in health.

As an all-island body, we welcome a harmonised, evidence-based approach to tobacco on this island. In this regard, we note the passing of a legislative consent motion in Northern Ireland this week, whereby the Northern Ireland Assembly agreed that Northern Ireland could be included in amendments to the UK Children and Families Bill, which includes standardised packaging. This is a step in the right direction.

Committee members' support for this Bill, which represents a significant and necessary step forward for tobacco control nationally and internationally, will help to retain Ireland’s reputation as a world leader in tobacco control. The measure will contribute to the goals of the public health policy, Healthy Ireland - A Framework for Improved Health and Wellbeing, to increase the proportion of people who are healthy at all stages of their life, to reduce health inequalities and to protect the public from threats to health and well-being. I thank the committee for its attention.