Wednesday, 9 May 2012
Protection of Children's Health from Tobacco Smoke Bill 2012: Second Stage
James Reilly (Minister, Department of Health; Dublin North, Fine Gael)
Tá áthas orm an Bille seo a ghlacadh ó na Seanadóirí, ach tá deacracht éigin leis agus caithfimid caint mar gheall ar sin.
I am delighted that Senators Crown, van Turnhout and Daly have put forward this Bill. As others have said, the topic of smoking in cars where children are present has received much public attention in the past year or so, although it was mooted a number of years before that by Dr. Fenton Howell and ASH. The Bill is now contributing to that welcome focus. This topic and the issue of smoking in public places is being discussed around the nation in kitchens, pubs, workplaces and on the airwaves. Getting people's attention on the issue and generating a debate can only be a very good thing, regardless of what view one takes on the matter. Mobilising public awareness on any issue is an important step if we wish to successfully change our lifestyle behaviours.
Senators are aware of my position on the issue. I have expressed it many times. I previously indicated my stance and I am committed to taking the steps necessary to significantly reduce smoking in this country. I am particularly committed to working towards a time when children and young people will come to regard smoking as a foolish and unattractive thing to do. I am fully in favour of legislating for a ban on smoking in cars where children are present. As others have mentioned, I wish to make the debate a bit wider. Like all things in life, when one brings about a change, there is a little bit of shock and an uncomfortable sense about it but as people have time to think the matter through, debate and discuss it and realise the pros and cons, one gets a greater understanding and willingness to embrace the change. As people take time to consider, debate and discuss the matter and realise the pros and cons involved, there will be a greater understanding of it and also, perhaps, more of a willingness to embrace the change, particularly when it is aimed at safeguarding those who do not have a voice and look to us to protect them.
I could have taken legal advice which would have suggested the Bill ought to be withdrawn. However, while there are numerous difficulties with the legislation, I am not going to seek its withdrawal because I want to accept it. We will have a great deal of work to do in ensuring it passes Committee Stage. There are a number of reasons for this which I will discuss in detail. As stated, the Government supports the Bill. I hope Senators will allow my officials and I to progress it through the legislative process.
A number of legal considerations arise in respect of the Bill in its current form. The first relates to seeking legal clarification on whether the Bill must be notified to the European Commission under the technical standards directive prior to its proceeding through the legislative process. If it does prove necessary to refer it to the Commission and other member states, the legal advice indicates that this could involve a standstill period of between three and six months. I hope such an eventuality will not come to pass.
There are several other issues with the Bill, one of which is the fact that the Senators are seeking to addend it to the public health (tobacco) (amendment) Bill which, in part, relates to the workplace. Clearly, a car is not always a workplace. As a result, a number of matters arise. We want to ensure the legislation is robust and effective in its operation. I am confident that by working together we can achieve this. If there are deficiencies in the Bill, they will be exploited and challenged by the tobacco industry.
I want to be clear about one matter and hope my previous utterances on it have been sufficiently transparent. The Bill is not concerned with restricting the rights of adults, rather it is about protecting the rights of children. Neither is it about attacking smokers. It seeks to ensure children will not be exposed to environmental tobacco smoke in cars. Children may not be aware of the dangers of exposure to environmental tobacco smoke and cannot remove themselves from risk if people smoke around them. As others have stated, the Bill will empower children, particularly those who are older, to speak up in defence of their own rights. We recognise that most people are sensible and would not expose their children to the risk to which I refer if they had full knowledge of the harm being caused. The Bill and the debate on it will make that knowledge available to them. However, there will still be irresponsible individuals who will put their own addiction and habit ahead of their children's health. We need to legislate for such individuals.
Like previous speakers, I emphasise that environmental tobacco smoke is a carcinogen and contains the same cancer causing substances and toxic agents inhaled by the smoker. There is no safe level of exposure to environmental tobacco smoke. It is obvious that exposure to cigarette smoke is particularly dangerous in enclosed spaces such as the interior of a car. Parents and others with responsibility for the welfare of children have a particular obligation to ensure such exposure does not take place.
We sometimes miss out on the relevant statistics. In that context, 5,200 people die every year as a result of conditions caused by tobacco smoking. This means that 5,200 families and communities are affected by the results of smoking. Those who die are are our brothers, sisters, fathers, mothers and friends. We do not want the next generation to suffer the same hardship and loss as that experienced by this generation and the one which preceded it.
Senator David Norris alluded to his own situation. I recall my father who was also a doctor informing me that if he had known at the age of seven years, when he began to smoke, what he had subsequently learned in his forties, he would never have taken up the habit. We all imitate what we see and denormalising smoking is about eliminating the images of smoking with which children are presented. Reference was made to the allure of smoking as portrayed on television and in films. I have clear and even fond memories from childhood of watching western films and then going to the shop to buy a bottle of red lemonade - very important that it was red - and a packet of sweet cigarettes. This was so that I could sit around drinking a glass of pretend whiskey, smoking a pretend cigarette and acting like I was a cowboy. Children learn by imitating their parents and other adults. We are all aware that in the early teenage years, peer pressure is a far greater influence than parental pressure.
As Senator John Crown observed, smoking in cars has been banned in a number of countries. We are undertaking a comprehensive review of such bans in the context of their effectiveness and how they have been implemented. We also require information on the level of compliance and methods of enforcement in the countries to which I refer. I have asked the Health Research Board to review all of the international evidence in this regard. I have also allocated money for the board to examine the reasons the prevalence of smoking in this country has not decreased, despite the smoking ban. Even though our children are not, as we were, exposed to tobacco advertising and do not see the brightly coloured cigarette packets on the shelf behind the sweet counter in their local shops, the prevalence of smoking remains stubbornly high at 29%. We need to discover what the tobacco industry is doing to ensnare the next generation.
If one were to consider this matter logically, one would ask children and young adults why they were prepared to pay the guts of €10 for a product that was going to cause them ill health, lead to their contracting cancer and cause them to die earlier than should be the case. Cancer is not the only condition to which tobacco smoking gives rise. People who smoke can also suffer heart attacks and strokes and contract peripheral vascular disease. In my medical practice I used to give patients who had diabetes and smoked a little piece of paper that was to be inserted into every box of cigarettes they bought and on which was written the following, "Diabetes plus smoking equals amputation". That is how bad smoking is for diabetics. The chances of diabetics who smoke losing, first, a toe and, later on, a limb are huge. In some cases, amputation is almost inevitable.
The Research Institute for a Tobacco Free Society has conducted research to estimate the prevalence of environmental tobacco smoke exposure in cars in Ireland. The initial research which covered almost 3,000 children aged 13 to 14 years indicated that 14.9% of children were exposed to smoking in cars. The Health Research Board's review, to which I referred, has highlighted a US survey which contains worrying statistics. It indicates that 23% of the 11 to 15 year olds surveyed stated they had been an occupant in a car with someone who was smoking in the week prior to their completing the questionnaire. Research carried out by the MRBI in 2007 on behalf of ASH Ireland showed 79% public support for the initiative in respect of smoking in cars. ASH Ireland also refers to an ongoing poll on irishhealth.com which shows that over 80% support a ban on smoking in cars. The levels of compliance and public support for smoke-free public places legislation demonstrate that people are keen to reduce their exposure to second-hand smoke. A study which considered smoking in the home after the smoke-free public places legislation had come into force in Scotland found that respondents had more robust restrictions on smoking in their cars than in their homes. While I am in no doubt that all parents, relatives and carers want to protect the health of the children in their care, sometimes the onus is on us, the policy and law makers, to remind people of their obligations in this regard. Again, I cannot help but re-emphasise the fact that this matter relates to children who have neither a voice nor a vote and who look to us to protect them. We have a duty of care to these children and must fulfil that duty.
The development of the legislation before the House is a way of reminding those who care about the welfare of their children not to light up in a car in which children are present. It will also serve as a punitive measure for those who knowingly continue to disregard the welfare of children. Peer pressure does count. When the legislation is eventually enacted, if one sees someone smoking in a car in which children are present, one will feel empowered and have every right to beep one's horn, roll down one's window and remonstrate with him or her. Taking action in respect of those who smoke in cars in which children are present is just one of the many matters being considered by my Department. As stated, smoking is the greatest single cause of preventable illness and premature death in Ireland. The number of premature deaths caused by tobacco use in Ireland is far greater than the combined death toll relating to car accidents, fires, heroin and cocaine abuse, murders and suicides. It is a shocking fact that we allow such a product to be used by minors. In 2000 the document, Towards a Tobacco Free Society, was adopted as Government policy. Our aim continues to be a move towards a tobacco-free society.
I am particularly concerned about the number of young people who continue to take up the habit each year. While it is heartening that the numbers of school-aged children who smoke has been decreasing steadily in recent years, more needs to be done to understand why young people start to smoke. My Department is smoking - I mean working. It certainly is not smoking.