Róisín Shortall (Dublin North West, Labour)

I thank Members who contributed to the debate and who put forward many interesting and worthwhile ideas. I welcome the cross-party support afforded to the legislation. I appreciate Members facilitating the taking of all Stages today.

The Bill is a technical measure, the purpose of which is to amend the 2009 Act in order to allow us to proceed to make the regulations to permit the use of graphic images on cigarette packets. It is no more and no less than that. It does not pretend to do anything other than that which I have already outlined.

This is an important element of the approach being taken to discourage people from smoking. We do not suggest it is a kind of panacea, nonetheless it is an important element in the battle against smoking.

I would like to respond to a number of points raised in the debate. A question was raised about nicotine replacement therapy and I would like to clarify that it is available free of charge to medical card holders. Unfortunately, the evidence is that lower socioeconomic groups are much more likely to smoke. We must examine the reasons for that. Other agencies must also take responsibility for contributing to the conditions which make people more inclined to smoke or to abuse alcohol or drugs. Along with the support available for people on medical cards, the HSE is doing considerable work in the area of smoking cessation programmes. It has also employed a number of smoking cessation counsellors to help people quit smoking. It is also involved in various social marketing campaigns to discourage smoking. Recently, a new billboard campaign was launched displaying the clear message that one out of every two smokers will die of a smoking related disease. Members may have seen some of those advertisements, which make a significant impact. There is a lot of work going on in this area.

A number of Members referred to the legal challenges being taken against the 2009 Act and other legislation. Given the scale of the profit that can be made from people smoking, such challenges are always a problem and the industry makes a huge effort to combat attempts made by governments to discourage smoking. The 2009 legislation restricted the display of cigarettes and advertising in retail outlets and those provisions are being challenged by Philip Morris International. I assure Members that the Department is preparing rigorously to defend the action in much the same way as was done with the P.J. Carroll litigation. The Department is liaising with the Office of the Chief State Solicitor and with the Attorney General in that regard.

Members also referred to the issue of the price of cigarettes. There is no doubt that, as with alcohol, the price of cigarettes is a key factor. Cigarette prices in Ireland are the highest in the world. It is €8.65 for a packet of 20 cigarettes, which is €1.50 more expensive than cigarettes in the UK, for example. The tax take from a packet of cigarettes is €6.71. We have made moves on the price of cigarettes and the Minister for Health has indicated that he intends to seek a further increase in the price of tobacco in the forthcoming budget. We have been active on that front. Related to the question of price is the illegal trade in cigarettes smuggled into this country. In many cases, this trade is a significant part of the activity of criminal gangs. Much work has been done by the Revenue Commissioners and customs officers in this regard. For example, in the period 2008-10, the Irish customs service seized a total of 532 million cigarettes, with an estimated retail value of €222 million, in just under 30,000 individual seizures.

It is estimated that at least 20% - retailers would say more - of all cigarettes smoked in this country are brought in illegally. This poses a huge challenge. While significant work is being done in this area, we need to go further. In that regard, I take on board the point made by Deputy Stanton with regard to the penalties and undertake to examine that issue. In addition to the cigarettes brought in illegally, significant numbers of cigarettes are brought in legally because of the high limit on the number of cigarettes that can be brought in personally. Unfortunately, people who have decided to profit from this area travel a lot back and forth, to eastern Europe in particular, to bring in bagloads of cigarettes which they then distribute in local housing estates and so on. This is a matter of concern and is an area I intend to examine.

I take the point made by Members with regard to the publication of the Quitline number on cigarette packets. The legislation we are dealing with today is just enabling legislation and the detail of what goes on a packet is not covered by it. That is a matter for the regulations. One of the selected 14 images includes the Quitline number. We will give that suggestion further consideration. There is a balance to be struck in what goes on the packet as only a limited portion of the packet can be devoted to these images. We want the image to be as stark and clear as possible. We are also required to include bilingual text. We must strike the balance between the text and how much of an image can be put on the package, but I will consider the points made with regard to the Quitline number.

With regard to young people who smoke, it is well known that the younger people are when they start smoking, the longer and more heavily they are likely to smoke. The majority of smokers become addicted in their childhood and teenage years and we need to break that cycle. This area has been the focus of much of the activity around discouraging smoking and discouraging young people from ever starting to smoke.

On the sale of cigarettes to minors, the tobacco legislation is enforced by the environmental health service of the HSE. As part of the enforcement of the legislation, the environmental health officers carry out test purchasing of tobacco products to minors. Last year, for example, the HSE carried out 402 test purchases to monitor compliance with the legislation. As a result, 12 prosecutions were taken for breaches, resulting in eight convictions, three dismissals and the application of the Probation Act in one case. There were six suspensions from the national register of tobacco retailers, varying in duration from one to 14 days.

Some Members suggested plain packaging on cigarettes. My immediate priority is to introduce this legislation so that we can go ahead with the regulations on the graphic images. The introduction of plain packaging will be considered by the tobacco policy review group, which is expected to report shortly. In Australia, the proposal to introduce legislation in this regard is being challenged by the tobacco industry. We await the outcome of that challenge with an open mind. If the evidence suggests that plain packaging is effective, we will give it consideration.

Deputy Finian McGrath spoke about smoke-free workplaces. Workers in pubs, restaurants, hotels and the catering industry generally have rights and we must be mindful of those rights. These workers have the right to have their health protected, which was a key factor in the case of the legislation introduced by Deputy Martin as Minister, and we must ensure their rights are protected. The evidence is, that since the smoking ban came into effect, there has been a considerable improvement in the health status of people working in this area. Compliance with the legislation has been consistently over 96%, indicating the success of this important measure. I understand it is not easy for smokers, but part of the approach taken is to discommode smokers and to make it difficult for them. For far too long, it was too easy to smoke anywhere, but now the notion of smoking on a plane or in the cinema is unthinkable. The more unacceptable and unimaginable we make smoking, the better. We cannot do that without restricting people and limiting the number of places where they can smoke. It is part of the strategy to do that and to make it less easy for people to smoke. We should not make any apologies for that.

Several Members, including Deputy Shane Ross, wondered whether the use of graphic images are effective. As I said in my opening comments, research from the United Kingdom and Belgium shows that shocking, stark images are indeed effective. In reference to road safety campaigns, several Members made the point that viewers tend to change channel when confronted with shocking images, thus potentially reducing their impact. However, the whole point of such images is to make us uncomfortable.

We are confident, in line with the view across Europe, that including graphic images on cigarette packaging will be effective in discouraging smoking. Smokers cannot switch off the image, as one can do with a television advertisement. Every time a smoker buys a packet of cigarettes or takes one from the pack, the graphic is unavoidable. We hope the images will have an impact over time in convincing people that the activity in which they are engaged will likely lead to ill health in later life. We must keep reinforcing that message, including by way of this measure. The inclusion of graphic images on cigarette packaging will make that message unavoidable.

I take on board the points made by Deputies in regard to the tone of the campaign. It is important that the anti-smoking message is not delivered in a lecturing and judgmental way. Our approach is, first, to put out the facts in a stark and clear way and, second, to ensure supports are in place, including easily accessible advice and counselling, as well as various products to assist in quitting the habit. It is very much a two-handed strategy.

I am heartened that so many Members emphasised the importance of placing a greater focus on health promotion within the health service. I hope to move in that direction in the coming months. We must face up to the large numbers of deaths in this State from smoking-related illness, alcohol abuse and poor diet. The reality is that some 80% of all illness is preventable. In other words, it is in people's own hands to maintain a healthy lifestyle and give themselves the best possible chance of avoiding serious illness. That message can be put across through effective information campaigns and the provision of effective supports and advice on how to adopt a healthier lifestyle.

I fully concur with Members who referred to the importance of positive role models for young people and of encouraging children to be involved in sport and to make positive choices. In regard to alcohol, I hope to take an initiative in the coming months and to bring proposals to the House in that regard. The time is right for such efforts; people realise we need to move towards a more health-conscious society and that it is imperative to take responsibility for improving one's own health status. It makes sense for people personally because it will offer them the potential for a much better quality of life. It also makes sense from the point of view of the health service, with a greater focus on health promotion potentially reducing the burden of disease on the system. That is the direction in which we are moving.

I thank Members for their worthwhile contributions on Second Stage and their cross-party support for the Bill.

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