Dr. Patrick Doorley:

Tobacco is a lethal, addictive drug. It is the most deadly consumer product ever marketed and it kills when it is used exactly as it is supposed to be used. One out of every two people who smoke long-term will die from tobacco. Tobacco kills 5,200 people in the country.

About three quarters of people who end up smoking have started as children. About the same proportion wish they had never started smoking. About the same proportion would like to quit smoking even if they feel they cannot do so right now. We need proportionate measures to tackle the scourge. It is one of the strong policy measures the faculty of public health medicine feels is badly needed.

Smoking prevalence in this country has declined from 29% in 2003 to 21% in 2012. Children's smoking rates have declined from 22% in 1998 to about 12%. The decline can be attributed to three strong policy measures. One is the tobacco taxation policy, which affects children disproportionately, the second is the ban on sales of tobacco in packets of less than 20, and the third is the removal of advertising at the point of sale. The point of it is that strong policy measures work. Government policy measures are among the strongest interventions we have to tackle tobacco addiction. In terms of the economics of tobacco, one of my former colleagues in the HSE has calculated that it costs hospital services alone €300 million per year. The cost to the entire health service is approximately €500 million. This has a huge impact on hospital beds. Government policy aims to reduce smoking prevalence from its current rate, 22%, to 5% by 2025. That is an extremely ambitious target that the faculty supports. It will require a rate of progress much more rapid than we have been achieving to date.

I refer to two systematic reviews of the evidence on plain packaging. I am talking about groups of experts who looked at high quality work. There is a lot of work that is not of a sufficiently high standard to be included in the review. The first review is mentioned by Dr. McAvoy and includes 37 studies conducted in different countries, including Australia, Canada, New Zealand and the UK, among men, women and children. The thrust of the studies goes in the same direction. The findings are that there is strong evidence to support the proposition relating to the role of plain packaging in helping to reduce smoking rates, that is, that plain packaging would reduce the attractiveness and appeal of tobacco products, would increase the noticeability and effectiveness of health warnings and messages, which is important because they are effective, and would reduce the use of design techniques that may mislead consumers about the harmfulness of tobacco products. In addition, the studies in the review show that plain packaging is perceived by both smokers and non-smokers to reduce initiation among smokers. One year later, the experts looked at the literature again and picked up another 17 studies that had been published after the initial review. The results were exactly the same.

That is the thrust of peer-reviewed research on plain packaging and its impact. It has a greater impact on children than adults in respect of initiation among children. That is very important. That is why the faculty of public health medicine strongly supports the measure. We have a few specific comments on the Bill. The packaging policy should take into account the possibility that variant descriptors, such as menthol and light, can mislead smokers into making inappropriate product attributions. The colour of the brand text, business or company name or variant name is not specified in the Bill and this is to be prescribed in the regulations. We recommend that the findings detailed in the reviews I mentioned relating to colour and perception should inform these regulations. The size and the dimensions of the packs should be specified in the Bill. Members may be aware that some packs are shaped like lipstick containers and these are attractive to young females and probably also to young children. The faculty of public health medicine welcomes the measure and, coming as it does in the context of recent policies in recent years, it brings us one step closer to the day when children in this country can grow up tobacco free.