Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Senator Noone for raising this very important issue. I will be responding on behalf of the Minister for Health, Deputy Simon Harris. The Senator will be aware that smoking is the greatest single cause of preventable illness and premature death in Ireland. It kills almost 6,000 people a year. Our primary objectives, set out in the 2013 policy document Tobacco Free Ireland are to denormalise smoking and to protect children from the dangers of tobacco consumption. That policy sets a target for Ireland to be tobacco free - that is having a smoking prevalence rate of less than 5% - by 2025. The Government and I remain committed to making Ireland tobacco free.

Tobacco Free Ireland contains a number of recommendations to assist smokers in quitting tobacco use. One of those recommendations is to examine the evidence regarding outcomes of the use of nicotine replacement therapy and other approaches. The Department requested that HIQA undertake a health technology assessment of the clinical and cost effectiveness of the pharmaceutical and non-pharmaceutical smoking cessation products and services. That assessment was published in 2017. It found that all pharmacological interventions were effective compared with no treatment. A prescription-only drug called varenicline was the most effective drug on its own.Using a combination of varenicline and nicotine replacement therapy was the most effective pharmacological intervention and people using this combination were over 3.5 times more likely to quit than those who were in a control group and did not receive this treatment.

Group behavioural therapy, individual counselling, intensive advice and telephone support were all found to be effective behavioural interventions, with group therapy found to be the most effective of these interventions. The addition of behavioural intervention to a pharmacological intervention improved the effectiveness of the intervention. The HIQA assessment recommended that smoking cessation services should seek to increase the uptake of varenicline, either alone or in combination with nicotine replacement therapy for smokers who want to use pharmacological support.

Although the health technology assessment found that results for e-cigarettes are promising, there is currently a lack of evidence to recommend their use as a smoking cessation aid, and currently no e-cigarette product is licensed as a medical product in Ireland. The safety of e-cigarettes is an evolving area of research. It is potentially safer than smoking but evidence on long-term safety has yet to be established. In the absence of additional evidence confirming the effectiveness of e-cigarettes, the HIQA assessment recommended that the HSE smoking cessation services should seek to increase the uptake of the combination nicotine replacement therapy treatment among those for whom varenicline is not tolerated or preferred.

The results of the HIQA health technology assessment will inform the development of the national clinical guidelines on smoking cessation interventions currently being undertaken by the Health Service Executive in conjunction with the national clinical effectiveness committee. It has also informed policy decisions on potential improvements to the provision of smoking cessation services in the public health service. The Department will continue to monitor the emerging research on all such products so as to inform decisions around any future additional regulation in the area. I thank the Senator for raising this very important matter.