Since the implementation of the national cancer strategy, a cumulative figure of €400 million has been invested in the development of cancer services. This level of investment is many times the increase of £25 million initially envisaged in 1996 to implement the national cancer strategy. The national cancer strategy acknowledges that the cause of most cancers is multifactorial, but that there is strong evidence that lifestyle factors, in particular smoking, alcohol and diet, play an important role. The promotion of healthy lifestyles is a key element of the work of the Department's health promotion unit and spending by the unit since the launch of the national cancer strategy on these topics is in excess of €17 million.