Catherine Murphy (Kildare North, Independent) | Oireachtas source

I regret that legislation is necessary owing to the judgment of the European Court of Justice in a case which was strongly defended by Ireland, Austria and France and in which it appears the European Union's fair market principles overrode public health concerns and interests. I question the morality of that approach and as a result, cannot support the legislation, notwithstanding that it is required of us to implement the court's judgment. One must ask what values the court is working to when an important vehicle to assist member states to inform and decide behaviour in public health matters is not permitted to be used. It is strange and must be galling for the Minister for Health who is a medical doctor to have to sponsor the Bill.

We have used minimum pricing since 1978 as a vehicle to reduce the incidence of smoking, which approach has had considerable success over the decades. I am sure smokers themselves wish to discourage others from smoking because of how addictive it is and the difficulties they experience in trying to kick the habit. This vehicle was being used to prevent people from becoming addicted in the first instance. The cost of smoking to the health service is greater than the revenue yielded from taxes on cigarettes. There is ample evidence of the damage cigarettes cause and it has been articulated by many. While one can talk about the evidence in an academic sense, people also talk about family members who smoke. My father died of lung cancer. When it is close up and personal and one has to watch for 12 months someone with less than an egg cup of capacity in his lungs gasp for breath, panic and experience pain, one is assured of the appropriateness of a health policy which discourages people from putting themselves in that position. No one would want his or her children to put themselves at that risk, which is what the health policy was intended to achieve. It was designed to stop young people, in particular, from starting to smoke in the first place.

One in every two people who is a life-long smoker will die from a smoking related illness. There are other significant effects of smoking, with 25% of all strokes being caused by cancer, for example. The incidence increases among young people, whereby more than half of young adults who experience a stroke are smokers. It is not merely about failing to survive a stroke, it is also about living with the damage the stroke will have caused to ruin a young person's life and limit his or her potential. We tend to think of older people when we think of strokes, but they can happen at any age.

The statistics are alarming. AVIVA carried out research recently which showed that 24% of Irish females and 22% of Irish males smoked. The amount of money spent on cigarettes is astonishing. Smokers spend €293 a month, or €3,500 per annum from taxed income. It is astonishing to consider the sum which has to be earned in gross wages by a person in the 41% tax band in order to pay for cigarettes. Research shows that smoking rates have actually increased recently and that women smoke twice as many cigarettes as men. We should seek every vehicle possible to discourage smoking. I smoked for a few years but gave them up a long time ago, before I became pregnant with my eldest child, and know how difficult it is to stop. I sympathise with those addicted to cigarettes, of whom very few would not give them up if they had a choice. Smoking is hugely addictive, expensive and damaging to health.

The cornerstone of Irish health policy to discourage the use of tobacco was price control, which is widely seen as the most successful tool to reduce the incidence of smoking. The policy has been successful in a number of countries. This is an almost textbook case of the ideals of free trade and open competition taking precedence over public health concerns to our detriment. A certain amount of industry lobbying will have been involved. We must engage at European level to change the values and attitudes which informed the decision. We should ensure the precedence of the European philosophy on free markets over public health and the social good is as temporary as possible.

Instances of lung cancer are increasing according to the Irish National Cancer Registry and estimates based on recent figures are for increases of 59% for men and 136% for women by 2020. There is no point in looking back and saying we could have done something to prevent this. We must do everything we can to reduce the figures. We need clear assurances from the Minister that the regime for the pricing of cigarettes will not change at the consumer end. We can implement the same restrictive pricing levels through taxation. While I cannot support the Bill, I would support legislation to ensure prices do not change at the consumer end. Ultimately, we will need to engage with the European Union on the issue. I want the Minister to assure the House that this will happen.

This is not simply about lung cancer. There are a range of cancers at issue. While the treatment of persons who have suffered a stroke is estimated to cost the health service €1 billion a year, the Irish Heart Foundation indicates that, unfortunately, less than €7 million is spent on community rehabilitation measures. A great deal of rehabilitation is required by the victim of a stroke who does not get to a stroke unit early, which is the ideal. What is even more ideal is ensuring someone will not have a stroke in the first place. Some 25% of all strokes are caused by smoking, which statistic rises to 50% among young adults as a result of a stroke caused by a blood clot.

Smoking is responsible for up to 2,500 strokes and 500 deaths from the disease every year according to the Irish Heart Foundation. We relate things to the death rate on our roads and this equates to road deaths. I know that not every stroke is preventable and that some strokes happen in old age but they happen across the age range. Young adults who smoke substantially raise their risk of stroke.

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